Factors Associated With Portal and Telehealth Uptake and Use in a Minoritized, Low-Income Community: Mixed Methods Study
Abstract BackgroundDespite evidence that use of patient portals and telehealth is associated with many health benefits, disparities exist in awareness, adoption, and use. Understanding factors and strategies specific to underserved populations is key to achieving digital equit...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-07-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2025/1/e70146 |
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| Summary: | Abstract
BackgroundDespite evidence that use of patient portals and telehealth is associated with many health benefits, disparities exist in awareness, adoption, and use. Understanding factors and strategies specific to underserved populations is key to achieving digital equity and better health.
ObjectiveThis study assesses portal and telehealth experiences among residents of a minoritized and lower-resource area of Dallas, Texas.
MethodsUsing an explanatory sequential design, we conducted surveys and semistructured interviews with English- and Spanish-speaking adults in 15 ZIP Codes surrounding a community-based clinic. We recruited participants via a patient portal, flyers, emails distributed by clinic and community partners, and in person. Surveys were offered online and on paper. We used Fisher exact tests to identify factors associated with telehealth and/or portal use. We also recruited a subsample of survey participants to expound on survey findings in semistructured interviews. Our thematic analysis assessed convergence in survey and interview findings.
ResultsAmong 182 survey respondents, most were older (n=109, 66%; age ≥60 years), African American or Black (n=120, 65%), and female (n=142, 79%); a little more than half (n=97, 54%) had completed ≥1 telehealth appointment, and a majority (n=131, 72%) had used a patient portal at least once. Compared with those who used the portal and/or telehealth, those reporting no use of portal or telehealth were more likely to have a high school education or less (PP
ConclusionsThis study builds on previous work by confirming and contributing insights about factors key to technology uptake and use among underserved populations. Interventions using digital health technologies should focus on these factors to promote digital and health equity and achieve better health outcomes. Future research should explore which clinical settings and contexts are most conducive to increasing digital technology uptake and use, and implementation should leverage partnerships with community groups. |
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| ISSN: | 2561-326X |