Usability of a Novel Mobile Health iPad App by Vulnerable Populations

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Abstract

Background

Recent advances in mobile technologies have created new opportunities to reach broadly into populations that are vulnerable to health disparities. However, mobile health (mHealth) strategies could paradoxically increase health disparities, if low socioeconomic status individuals lack the technical or literacy skills needed to navigate mHealth programs.

Objective

The aim of this study was to determine whether patients from vulnerable populations could successfully navigate and complete an mHealth patient decision aid.

Methods

We analyzed usability data from a randomized controlled trial of an iPad program designed to promote colorectal cancer (CRC) screening. The trial was conducted in six primary care practices and enrolled 450 patients, aged 50-74 years, who were due for CRC screening. The iPad program included a self-survey and randomly displayed either a screening decision aid or a video about diet and exercise. We measured participant ability to complete the program without assistance and participant-rated program usability.

Results

Two-thirds of the participants (305/450) were members of a vulnerable population (limited health literacy, annual income < US $20,000, or black race). Over 92% (417/450) of the participants rated the program highly on all three usability items (90.8% for vulnerable participants vs 96.6% for nonvulnerable participants, P=.006). Only 6.9% (31/450) of the participants needed some assistance to complete the program. In multivariable logistic regression, being a member of a vulnerable population was not associated with needing assistance. Only older age, less use of text messaging (short message service, SMS), and lack of Internet use predicted needing assistance.

Conclusions

Individuals who are vulnerable to health disparities can successfully use well-designed mHealth programs. Future research should investigate whether mHealth interventions can reduce health disparities.

Related collections

Most cited references 33

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Author and article information

Contributors

David P Miller Jr:

Wake Forest School of MedicineDepartment of Internal MedicineMedical Center BoulevardWinston-Salem, NC, 27157United States1 336 713 41561 336 716 7359dmiller@wakehealth.edu

ORCID: http://orcid.org/0000-0001-7879-4427

Journal

Journal ID (nlm-ta): JMIR Mhealth Uhealth

Journal ID (iso-abbrev): JMIR Mhealth Uhealth

Journal ID (publisher-id): JMU

Title: JMIR mHealth and uHealth

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2291-5222

Publication date Collection: April 2017

Publication date (Electronic): 11 April 2017

Volume: 5

Issue: 4

Electronic Location Identifier: e43

Affiliations

[1] ¹Wake Forest School of Medicine Department of Internal Medicine Winston-Salem, NCUnited States

[2] ²Wake Forest School of Medicine Department of Social Sciences & Health Policy Winston-Salem, NCUnited States

[3] ³Wake Forest School of Medicine Department of Biostatistical Sciences Winston-Salem, NCUnited States

[4] ⁴Wake Forest Health Sciences Enterprise Information Management Winston-Salem, NCUnited States

[5] ⁵University of Texas Dell Medical School Department of Internal Medicine Austin, TXUnited States

[6] ⁶Wake Forest School of Medicine Department of Family & Community Medicine Winston-Salem, NCUnited States

Author notes

Corresponding Author: David P Miller Jr dmiller@ 123456wakehealth.edu

Author information

David P Miller Jr http://orcid.org/0000-0001-7879-4427

Kathryn E Weaver http://orcid.org/0000-0001-9006-4064

L Doug Case http://orcid.org/0000-0002-5706-4377

Donald Babcock http://orcid.org/0000-0003-1899-5731

Donna Lawler http://orcid.org/0000-0001-6737-9818

Nancy Denizard-Thompson http://orcid.org/0000-0002-8498-0792

Michael P Pignone http://orcid.org/0000-0002-6657-7342

John G Spangler http://orcid.org/0000-0002-7949-7050

Article

Publisher ID: v5i4e43

DOI: 10.2196/mhealth.7268

PMC ID: 5405290

PubMed ID: 28400354

SO-VID: 8994c56e-675a-4264-a8e5-39d1e51c950f

Copyright © ©David P Miller Jr, Kathryn E Weaver, L Doug Case, Donald Babcock, Donna Lawler, Nancy Denizard-Thompson, Michael P Pignone, John G Spangler. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 11.04.2017.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 5 January 2017

Date revision requested : 28 January 2017

Date revision received : 7 February 2017

Date accepted : 9 March 2017

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