JMIR Publications

ABSTRACT

Despite the proliferation of ehealth interventions such as web portals for health information dissemination, or mobile apps for health monitoring and education, research has shown that individuals from underserved communities do not benefit proportionately from these ehealth interventions because of the lack of attention to usability design leading to low uptake, as well as the lack of understanding on the researchers part on what are the structural, physical, and physchological barriers to technology adoption. In the design of ehealth interventions for underserved groups, it is important to pay attention to the different types of barriers faced by them in availing of and benefiting form e-health interventions. The objective of this paper is to draw lessons from a decade of experience in designing different user-centered ehealth interventions (e.g., web portals, health app) to inform future works in leveraging technology to address health disparities. We draw these lessons from a series of interventions from the work we have done over 15 years including three that specifically used webportals and health apps targeted towards unerserved groups. The projects were: (a) Click to Connect (C2C): A community- based eHealth intervention whose goal was to improve Internet and health literacy among underserved communities groups by providing home access to high-speed Internet, computer and Internet training classes, a Web portal that facilitates Internet navigation, and ongoing technical support; (b) PLANET MassCONECT: A knowledge translation project that builds capacity to adopt evidence-based health promotion programs among community based organizations in Boston, Lawrence, and Worcester in Massachusetts, and (c) SNAP: a mobile health research that collects both participatory (e.g., surveys) and passive data (e.g., geolocations, web-browsing behaviors) for the purpose of understanding tobacco message exposure in individuals’ built environment. From the lab’s experiences, we distilled five principles for researchers that aim to design e-health interventions for underserved communities. They are: (a) Develop a strategic roadmap in addressing communication inequalities; (b) Design with both readability and navigability in mind; (c) Build privacy safeguards into e-health interventions, and communicate privacy-utility trade-offs in simplicity; (d) Engage multiple stakeholders for the long haul; and (e) Strive for an optimal balance between open science aspirations and protection of underserved communities.