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

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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
    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
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    References listed on IDEAS

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    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.
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