Understanding Multi-Level Factors Impacting Digital Health Literacy in the Deep South of the United States

Tanvi V. Padalkar, Keyonsis Hildreth, Gabrielle B. Rocque, Stacey A. Ingram, Omari Whitlow, Dan Chu, Connie C. Shao, Courtney P. Williams, Claudia M. Hardy, Chao-Hui Sylvia Huang and Nicole L. Henderson ()
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Tanvi V. Padalkar: Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Keyonsis Hildreth: Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Gabrielle B. Rocque: Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Stacey A. Ingram: Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Omari Whitlow: Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Dan Chu: Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Connie C. Shao: Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Courtney P. Williams: O’Neal Comprehensive Cancer Center, Birmingham, AL 35233, USA
Claudia M. Hardy: Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Chao-Hui Sylvia Huang: Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Nicole L. Henderson: Department of Medicine, Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL 35233, USA

IJERPH, 2024, vol. 22, issue 1, 1-15

Abstract: As healthcare and health services become increasingly digitized, individuals with low digital health literacy (DHL) may experience inequitable care and outcomes. We explored factors impacting DHL and recommendations for improvement from community health coordinators and advisors (CHAs) in Alabama and Mississippi in United States. Semi-structured interviews were conducted with CHAs to gather insights on their perspectives on and experiences with DHL. Interviews were transcribed and analyzed using a grounded coding schema, with key barriers and recommendations mapped onto the Taplin Multi-Level Intervention model to help identify influences across various levels. Thirty-two CHAs participated, predominantly female (94%) and Black or African American (94%). At the individual level, factors involved demographic characteristics, increased patient workload, and attitudes towards technology. Social support was captured at the relationships level. At the provider level, provider–patient communication and injustices were involved, compounded by health system infrastructure and culture at the practice-setting level. Resource landscape and shared knowledge and beliefs were significant at the community level. The COVID-19 pandemic further highlighted these challenges at the societal level. CHAs provided targeted recommendations for addressing barriers at each level. CHAs identified multi-level factors contributing to DHL and emphasized levels based on comprehensive interventions.

Keywords: digital health literacy; community health advisors; Taplin Multi-Level Model (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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