mHealth Technology Use and Implications in Historically Underserved and Minority Populations in the United States: Systematic Literature Review

Abstract

BackgroundThe proportion of people in the United States who are members of at least two ethnic groups is projected to increase to 10% by the year 2050. This makes addressing health disparities and health inequities in minority populations increasingly more difficult. Minority populations, including those who classify themselves as African American and Hispanic, are using mobile phones to access health information via the internet more frequently than those who classify themselves as white, providing unique opportunities for those in public health and health education to reach these traditionally underserved populations using mobile health (mHealth) interventions.ObjectiveThe objective of this review was to assess studies conducted in the United States that have used mHealth tools and strategies to develop and implement interventions in underserved populations. This review also examines the ways in which mHealth strategies are being employed in public health interventions to these priority population groups, as mobile phone capabilities include text messaging, mobile apps, internet access, emails, video streaming, social media, instant messaging, and more.MethodsA systematic literature review was conducted using key search phrases, the matrix method, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart diagram to identify key studies conducted between the years of 2009-2016 in the United States. These studies were reviewed for their use of mHealth interventions in historically underserved and minority populations.ResultsA total of 16,270 articles were initially identified using key search phrases in three databases. Titles were reviewed and articles not meeting criteria were excluded, leaving 156 articles for further review. After additional review for relevance and inclusion criteria, 16 articles were qualified and analyzed.ConclusionsmHealth is a promising area of development for public health and health education. While successful research has been done using text messaging (short message service, SMS) and other mHealth strategies, there is a need for more research using mobile phones and tablet applications. This literature review demonstrates mHealth technology has the ability to increase prevention and health education in health disparate communities and concludes that more specified research is needed.

Preferences of mHealth app features for weight management among breast cancer survivors from underserved populations

“…A systematic review found digital interventions for cancer survivors resulted in improved moderate to vigorous physical activity behaviors and body weight; data was mixed for diet behaviors . However, key questions remain in terms of how mHealth interventions should be optimally designed for breast cancer survivors from underserved populations based on their cultural and literacy differences and the cancer‐related disparities they face . Obesity disproportionally affects underserved populations, and excess weight is associated with increased risk of recurrence and decreased survival among breast cancer survivors .…”

The Balance protocol: a pragmatic weight gain prevention randomized controlled trial for medically vulnerable patients within primary care

“…As obesity and its comorbidities continue to plague our patients and health systems, there is an increasing need to provide comprehensive obesity treatment within primary care with maximal reach to patients, particularly those who reside in remote areas. Digital technologies can facilitate the reach of efficacious treatments to medically vulnerable patients [66][67][68], those in dire need of effective weight management programs, but with the least access to these interventions [10,11,[69][70][71]. Comprehensive obesity treatment solutions that comprise both weight loss and weight gain prevention interventions are particularly needed, especially by those in medically vulnerable circumstances.…”

Digital interventions for parents of acutely ill children and their treatment-seeking behaviour: a systematic review

“…It has been well documented that parents with lower health literacy are more likely to seek out-ofhours health care unnecessarily for non-urgent complaints (32) (33), and a recent systematic review has highlighted that mhealth apps may be of particular benefit in this group, and have the potential to reduce disparities in healthcare (34). Lepley et al note that the use of jargon and complex sentences in their 'Children's On Call' advice app may have been responsible for its poor acceptability, particularly given that over half their study population had low health literacy.…”