Digital health tools, such as patient portals, treatment apps and online appointment schedulers, are increasingly common. But not everyone is equally at home using them.

To find out how language, education and age may affect a person’s comfort in using digital tools, UC San Francisco researchers surveyed caregivers of hospitalized children at UCSF Benioff Children’s Hospitals.

The researchers found that being a Spanish speaker, having less education, and being older all made people feel less comfortable with digital health tools.

“Digital health tools are meant to improve health access and outcomes, but they must be useful for people from all backgrounds to avoid deepening existing health inequities,” said Naomi Bardach, MD, professor of pediatrics at UCSF Benioff Children’s Hospitals.

“We don’t want to leave people behind, whether they are older adults, people with lower education, or those of a specific race, ethnicity or language background.”

The study appears Dec. 17 in the Journal of the American Medical Informatics Association.

Comfort levels could affect treatment

Researchers asked how well people felt they could engage with digital tools, how motivated they were to use them, and how safe and in control they felt while they were using them. This was intended to measure people’s concerns about the privacy of digital health tools.

Education was the most important factor, after language. Having a high school education or less was most strongly associated with lower scores in all three areas measured.

Latinx and Black caregivers scored significantly lower on “feeling safe and in control” with digital tools. Rural caregivers, however, scored higher on the privacy measure, and they were more motivated to use digital tools.

Those over 45 were less motivated to use digital tools, and they also felt less safe and in control while using them. But they felt able to engage with them if they wanted to.

“Accessing these tools affects all kinds of things, like requesting medication refills online, tracking the number of steps per day, or helping a child play a therapeutic game for ADHD,” Bardach said.

“We all need to be thinking about how to make sure people can use them comfortably, and if they can’t, how to provide an alternative.”