The Efficacy of Health Information Technology in Supporting Health Equity for Black and Hispanic Patients With Chronic Diseases: Systematic Review

Abstract

Background Racial inequity persists for chronic disease outcomes amid the proliferation of health information technology (HIT) designed to support patients in following recommended chronic disease self-management behaviors (ie, medication behavior, physical activity, and dietary behavior and attending follow-up appointments). Numerous interventions that use consumer-oriented HIT to support self-management have been evaluated, and some of the related literature has focused on racial minorities who experience disparate chronic disease outcomes. However, little is known about the efficacy of these interventions. Objective This study aims to conduct a systematic review of the literature that describes the efficacy of consumer-oriented HIT interventions designed to support self-management involving African American and Hispanic patients with chronic diseases. Methods We followed an a priori protocol using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses)-Equity 2012 Extension guidelines for systematic reviews that focus on health equity. Themes of interest included the inclusion and exclusion criteria. We identified 7 electronic databases, created search strings, and conducted the searches. We initially screened results based on titles and abstracts and then performed full-text screening. We then resolved conflicts and extracted relevant data from the included articles. Results In total, there were 27 included articles. The mean sample size was 640 (SD 209.5), and 52% (14/27) of the articles focused on African American participants, 15% (4/27) of the articles focused on Hispanic participants, and 33% (9/27) included both. Most articles addressed 3 of the 4 self-management behaviors: medication (17/27, 63%), physical activity (17/27, 63%), and diet (16/27, 59%). Only 15% (4/27) of the studies focused on follow-up appointment attendance. All the articles investigated HIT for use at home, whereas 7% (2/27) included use in the hospital. Conclusions This study addresses a key gap in research that has not sufficiently examined what technology designs and capabilities may be effective for underserved populations in promoting health behavior in concordance with recommendations.

The Use of Digital Health Tools for Health Promotion Among Women With and Without Chronic Diseases: Insights From the 2017-2020 Health Information National Trends Survey

“…Overall, our results suggest that women with chronic conditions were more likely to report using digital health tools than those without these conditions. These findings are similar to previous studies showing increased digital health use, especially among those with chronic diseases [19,[23][24][25]. A difference in digital health use was also noted based on the type of condition reported.…”

“…For instance, older adults are an at-risk cohort with higher disease rates and more health care needs, as well as the fastest growing group, yet they are largely disconnected from the digital world [ 19 , 23 ]. Low-income minority groups experience barriers due to the limited availability and affordability of mobile services and internet limitations [ 24 ]. In this current age of technology, digital inclusion and literacy have been deemed “super social determinants of health” as they address all other health determinants [ 11 , 25 ].…”

A retrospective analysis of the social determinants of health affecting stroke outcomes in a small hospital situated in a health professional shortage area (HPSA)

“…These organizations also agree that work needs to be done on understanding the reasons underlying the causes of these disparities, stating that clinical trials specifically take steps to address the disparity data collected, and that outreach to these communities needs to be undertaken in non-traditional settings (churches and barbershops for example). Furthermore, a concerted effort to use mobile health technology, and effective interventions by non-physicians to reach disparity groups needs to be made to ensure these members of society do not continue to be left behind [49][50][51]. Experts have even suggested that priority should be given to culturally tailored interventions to decrease the incidence of recurrent stroke in underserved populations [7].…”