The role of economic, educational and social resources in supporting the use of digital health technologies by people with T2D: a qualitative study

Abstract

Background Type 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity. Study aims To gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups. Methods A purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically. Results A diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender. Conclusion This research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.

Patients’ Views on the Design of DiabeText, a New mHealth Intervention to Improve Adherence to Oral Antidiabetes Medication in Spain: A Qualitative Study

“…Social support (from friends and family) was perceived as key requisite to overcome these limitations. In a recent qualitative study with 21 participants with T2DM, they also described technical proficiency as a main barrier to access and use of information and communication technologies, but they were motivated to receive social support to use them because they provided selfcare support, a feeling of control over T2D, and personalized advice or feedback [46]. In fact, some participants self-identified as early adopters and technophiles, while others felt less able to navigate new innovations but were still using them, as we also described in this study.…”

Improving Access to Behavioral Strategies to Improve Mental Well-being With an Entertaining Breakfast Show App: Feasibility Evaluation Study

“…explored in this trial was less accessible or appealing to people from lower socioeconomic groups. Low uptake can be influenced by a variety of factors, such as low digital literacy, lack of awareness of the app, low availability and accessibility, lack of recommendations from other people to use the app, and lack of support to navigate new technology [ 54 , 55 ]. The difference in use has been explored in several systematic reviews, but the evidence regarding socioeconomic characteristics is inconclusive.…”

Patient Readiness for Remote Healthcare Services in the Context of the COVID-19 Pandemic: Evidence From European Countries

“…In another research, chronic diseases, higher age, lower income, lower educational levels, living alone, and living in rural areas were found to be associated with lower use of digital health tools ( 33 ). The importance of demographic characteristics of patients using digital healthcare services is also highlighted, among others, in ( 9 , 34 – 36 ).…”