Health Literacy and Consumer-Facing Technology Workshop Summary (2015) / Chapter Skim
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5 Health Information Technology and Selected Populations
5 Health Information Technology and Selected Populations
Pages 63-80
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From page 63... ...
Elizabeth Jordan, associate professor and senior assistant dean of undergraduate nursing at the University of South Florida's College of Nursing, described how mobile technologies can provide critical information that can help pregnant women and new mothers improve their health and the health of their babies. Winston Wong, medical director at Kaiser Permanente discussed the promises and perils of technology that were brought up in an IOM workshop on digital health strategies, health disparities, and health equity conducted by the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities.
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From page 64... ...
You would have built something for someone like me assuming something. Knowing something about me though, you might now build something different." Turning to the subject of addressing structural health disparities and the digital divide facing Native American populations, Kim explained that there are 3.7 million American Indian and Alaskan Native people in the United States.
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From page 65... ...
Nonetheless, public and tribal libraries are now providing critical access to health information to Native Americans, and she noted that NLM has a Native American outreach program to create targeted health-related content and to support developing the infrastructure to tribal communities. Once infrastructure is in place, it is then possible to think about how to use that infrastructure to improve the health of these underserved communities, but as Kim noted, little research has been done on the best way to do so for Native American communities.
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From page 66... ...
After several weeks of training, tribal youth were able to design a research project and use mobile technology to conduct the research. Kim noted that four members of the youth research team presented the first results of this project to a packed room of physicians, nurses, researchers, and community members at the University of California, Davis, Clinical Translational Sciences Center.
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From page 67... ...
The results showed that the two were strongly related and so the youth researchers decided to do something around physical activity because that had an impact on confidence about food. Kim and her colleagues suggested that the youth researchers make a game out of their intervention, but the youth researchers said that collaboration, not competition, is a core tribal value.
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From page 68... ...
. Other tudies have s shown in randomized controlled trials that text messaging can improve influenza vaccination rates among low-income, urban children, adolescents, and pregnant women (Hofstetter et al., 2015; Stockwell et al., 2015)
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From page 69... ...
Johnson & Johnson provided the initial funding, but the program now has more than 1,100 sponsors promoting it, including the White House Office of Science and Technology Policy and HHS. The program focuses on delivering messages to pregnant women and mothers with children under age 1 on a range of key topics, including smoking cessation, breastfeeding, health care access, diabetes, nutrition, oral health, immunization, prenatal care, disabilities, family planning, HIV/AIDS prevention, violence prevention, physical activity, safety and injury prevention, mental health, substance abuse prevention, developmental milestones, labor and delivery, car seat safety, safe sleep, and exercise.
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From page 70... ...
Of the 267 messages that the program sends out, 58 percent contain additional health and resource information, 46 percent contain links to the text4baby mobile webpages developed in partnership with major medical associations, and 25 percent provide a phone number for resources such as local food banks and domestic violence hotlines. There are also 45 links to informational videos and 15 visit and appointment reminders.
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From page 71... ...
He also explained that the meeting was held in Detroit because it has some of the worst health disparities in the United States, particularly with regard to infant mortality. The focus of that workshop was to explore how communities are using digital health technologies to improve health outcomes for vulnerable population groups and to investigate community engagement efforts to improve access to high-quality health information.
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From page 72... ...
"We saw mobile health applications that had to do with connecting people to healthy foods, to WIC vouchers, and other things that were not just about engaging individuals with regard to health behaviors, but also connecting people to resources," said Wong. Mobile health technology, said Wong, can reduce the digital divide and mobile technology allows for customizing digital health technology.
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From page 73... ...
However, usage is not equitable across all groups and there are Kaiser members who have access, who do not have access but want it, and who do not have access and do not want it. The moral of the story, said Wong in his concluding remarks, is that digital health technologies have the potential to both exacerbate and diminish already existing disparities among population groups.
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From page 74... ...
"I do think that there is a need for rigorous evaluations that might be in lieu of the randomized controlled trial," she said. Kim addressed the question by first noting that it is not just health literacy that needs to be accounted for, but also community literacy on the part of the researcher.
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From page 75... ...
Lindsey Robinson, trustee for the 13th District of the American Dental Association, noted that health disparities also extend to dental health and that 80 percent of the disease burden affects 20 percent of the population. In fact, she said, CDC recently released data showing that there has been a modest improvement in reducing the prevalence of dental caries in young white children, but not in Hispanics and African Americans.
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From page 76... ...
Jeffries wondered if those communities even know about the prevalence of oral health problems, and Wong noted that in the Alaskan Native population, the incidence of dental caries has soared over the past two generations. He suggested that embracing the knowledge of elders and their culture could play an important role here, just as it did when developing the walking game in Kim's project.
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From page 77... ...
Wong added that this idea is the foundation on which most of the historic health maintenance organizations were established. Addressing Kim, Logan said that one of the challenges that NLM finds in working with Native American communities is that many Native Americans live in urban areas now, not on reservations.
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From page 78... ...
There is health system money going into that. There is public health department money going into that." She noted that there was a Robert Wood Johnson Foundation Quantified Self Public Health workshop being held in which the conversation was going to be about how to bring those in public health and community health together with technology people and develop a business model that incentivizes companies to take on this mission.
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From page 79... ...
From her perspective as someone who has been thinking about how to apply universal precautions to all of her communications with patients, she said she believes digital health can help with this. The challenge will be for big companies such as hers, where things do not happen fast, to work with small, nimble technology companies to address these needs in a way that benefits the health of the nation sooner rather than later.
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