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Informing mHealth Delivery in Healthcare Settings

 Exploratory research to evaluate digital healthcare practices of safety-net patients and the perceptions of their healthcare providers about strategies needed to support digitally-engaged patients.


Casa Ruby Center, Washington DC

HealthPoint Community Health Centers, Washington 

The Women’s Collective Community Health and Human Service Center, Washington DC

Trinity Washington University, Department of Psychology

Study Description

This five-year bicoastal exploratory study evaluated safety-net patients’ engagement in digital healthcare management via investigator-administered surveys to respondents accessing services at community health centers in Washington state and DC. The surveys queried patients about their current use of mobile devices for self-care management, barriers to engagement, and assessment of care received at current healthcare facilities.
The second phase of the study utilized focus group methodology to query healthcare providers about perceived barriers to integrating remote patient data into clinical practices and their insights about the type of clinical decision supports needed to work with safety-net patients using mHealth technology for care management outside clinic settings.


76% of safety-net patients use smartphones for healthcare support

48% use health-based mobile apps for self-care management

Among the safety-net sample, females (79%), younger adults 18 – 29 years (84%), and individuals with high school education or higher (77%) are more likely to use their mobile phones to acquire health information relative to their counterparts 

Poorest of poor patients (<20k) are significantly less likely to use mobile technology for healthcare management

Ethnicity predicts use of health applications, with Hispanic communities most likely to use this technology

Patients who receive support during a clinical visit to engage in physical activity are almost three times more likely to use health-based mobile applications for care management

Access to specialized services makes a substantial positive impact on safety-net patients’ feelings of optimism about their health and well-being

Clinicians perceive some barriers to integrating remote digital-based data from their patients into existing work but are optimistic about the value of remote health status monitoring data to support patient care delivery

Clinicians report that an mHealth Clinical Practice Guide can be useful when working with digitally-engaged safety-net patients. The guide must (1) provide information about evidence-based mobile applications; (2) link to community services that support healthcare engagement and target Social Determinants of Health factors, and, (3) provide a profile of patients likely to engage in digital healthcare management


2015 to 2019