IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v22y2024i1p41-d1557398.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    O’Neal Comprehensive Cancer Center, 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
    Department of Medicine, Division of General Internal Medicine and Population Science, University of Alabama at Birmingham, 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)

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.

Suggested Citation

  • 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 & Nicole L. , 2024. "Understanding Multi-Level Factors Impacting Digital Health Literacy in the Deep South of the United States," IJERPH, MDPI, vol. 22(1), pages 1-15, December.
  • Handle: RePEc:gam:jijerp:v:22:y:2024:i:1:p:41-:d:1557398
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/22/1/41/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/22/1/41/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Sophia Herrera & Alide Salazar & Gabriela Nazar, 2022. "Barriers and Supports in eHealth Implementation among People with Chronic Cardiovascular Ailments: Integrative Review," IJERPH, MDPI, vol. 19(14), pages 1-13, July.
    2. Witmer, A. & Seifer, S.D. & Finocchio, L. & Leslie, J. & O'Neil, E.H., 1995. "Community health workers: integral members of the health care work force," American Journal of Public Health, American Public Health Association, vol. 85(8), pages 1055-1058.
    3. Samar J. Melhem & Shereen Nabhani-Gebara & Reem Kayyali, 2023. "Digital Trends, Digital Literacy, and E-Health Engagement Predictors of Breast and Colorectal Cancer Survivors: A Population-Based Cross-Sectional Survey," IJERPH, MDPI, vol. 20(2), pages 1-23, January.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jiyun Kim & Yuna Paik & Seungmi Park, 2022. "Cancer Screening Program Delivered by Community Health Workers for Chinese Married Immigrant Women in Korea," IJERPH, MDPI, vol. 19(11), pages 1-9, May.
    2. Alan Kirschenbaum, 2021. "Reducing patient surge: community based social networks as first responders," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 108(1), pages 163-175, August.
    3. Arima, Yuzo & Guthrie, Brandon L. & Rhew, Isaac C. & De Roos, Anneclaire J., 2009. "The impact of the First Steps prenatal care program on birth outcomes among women receiving Medicaid in Washington State," Health Policy, Elsevier, vol. 92(1), pages 49-54, September.
    4. David García-García & María Julia Ajejas Bazán & Francisco Javier Pérez-Rivas, 2022. "Factors Influencing eHealth Literacy among Spanish Primary Healthcare Users: Cross-Sectional Study," IJERPH, MDPI, vol. 19(23), pages 1-13, November.
    5. Visram, Shelina & Walton, Nick & Akhter, Nasima & Lewis, Sue & Lister, Graham, 2020. "Assessing the value for money of an integrated health and wellbeing service in the UK," Social Science & Medicine, Elsevier, vol. 245(C).
    6. Galárraga, Omar & Quijano-Ruiz, Alonso & Faytong-Haro, Marco, 2024. "The effects of mobile primary health teams: Evidence from the Médico del Barrio strategy in Ecuador," World Development, Elsevier, vol. 181(C).
    7. Ilona Sips & Ahmad Haeri Mazanderani & Helen Schneider & Minrie Greeff & Francoise Barten & Mosa Moshabela, 2014. "Community Care Workers, Poor Referral Networks and Consumption of Personal Resources in Rural South Africa," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-7, April.
    8. Greene, George J. & Reidy, Emma & Felt, Dylan & Marro, Rachel & Johnson, Amy K. & Phillips, Gregory & Green, Evelyn & Stonehouse, Patrick, 2022. "Implementation and evaluation of patient navigation in Chicago: Insights on addressing the social determinants of health and integrating HIV prevention and care services," Evaluation and Program Planning, Elsevier, vol. 90(C).
    9. López-Sanders, Laura, 2017. "Changing the navigator's course: How the increasing rationalization of healthcare influences access for undocumented immigrants under the Affordable Care Act," Social Science & Medicine, Elsevier, vol. 178(C), pages 46-54.
    10. South, Jane & Purcell, Martin E. & Branney, Peter & Gamsu, Mark & White, Judy, 2014. "Rewarding altruism: Addressing the issue of payments for volunteers in public health initiatives," Social Science & Medicine, Elsevier, vol. 104(C), pages 80-87.
    11. Estelle D. Watson & Shabir Moosa & Dina C. Janse Van Rensburg & Martin Schwellnus & Estelle V. Lambert & Mark Stoutenberg, 2023. "Task-Shifting: Can Community Health Workers Be Part of the Solution to an Inactive Nation?," IJERPH, MDPI, vol. 20(17), pages 1-13, August.
    12. Judith Nalukwago & Rik Crutzen & Bart van den Borne & Paul Mukisa Bukuluki & Leonard Bufumbo & Richard Batamwita & Amos Zikusooka & Rachel Lenzi & Gretchen Thompson & Jane Alaii, 2018. "Adolescents Discussing Sexual Behaviors With Key Influencing Audiences," Global Journal of Health Science, Canadian Center of Science and Education, vol. 10(8), pages 1-91, August.
    13. Kash, Bita Arbab & May, Marlynn Lee & Tai-Seale, Ming, 2007. "Community health worker training and certification programs in the United States: Findings from a national survey," Health Policy, Elsevier, vol. 80(1), pages 32-42, January.
    14. May, Marlynn L. & Contreras, Ricardo B., 2007. "Promotor(a)s, the organizations in which they work, and an emerging paradox: How organizational structure and scope impact promotor(a)s' work," Health Policy, Elsevier, vol. 82(2), pages 153-166, July.
    15. Nunes, João & Lotta, Gabriela, 2019. "Discretion, power and the reproduction of inequality in health policy implementation: Practices, discursive styles and classifications of Brazil's community health workers," Social Science & Medicine, Elsevier, vol. 242(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:22:y:2024:i:1:p:41-:d:1557398. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.