Reducing the Health and Digital Divides: A Model for Using Community-Based Participatory Research Approach to E-Health Interventions in Low-Income Hispanic Communities

Abstract

Low-income Hispanics are the most digitally underserved population in the U.S. This article examines the potential of community-based participatory research approach to e-health to decrease the disparities in access to technology and health information in low-income Hispanic communities. To demonstrate this framework, we describe the process of designing a community-based e-health intervention to increase knowledge and parental self-efficacy in coping with young children's mental health problems including mental health service utilization. Our model incorporates utilizing promotoras de salud (lay community health educators) and community media principles to create the content of e-health interventionsand train community members in using the technology. This case study illustrates the processes involved in using this approach, barriers for participatory e-health interventions in bridging the Digital Divide, and lessons learned.

Ethnicity, digital divides and uses of the Internet for health information

“…So the underlying concern about extending Internet access to nonusers who likely remain deterred by information literacy barriers remains, and thus represents an important focus for policymakers. This might involve federal government initiatives to extend affordable ''wi-fi'' access to low income rural areas, as well as local efforts to extend free Internet access in urban areas (e.g., Ginossar & Nelson, 2010;NTIA, 2004NTIA, , 2010Rogers, 2003). Later work should investigate these influences with more demographically and geographically diverse samples.…”

“…Although digital divide conceptions define Internet access in terms of race and class disparities (e.g., Ginossar & Nelson, 2010;Jeffres, Neuendorf, & Atkin, 2012;Laz & Berenson, 2013;Lee, Ramirez, Leis, Gray, & Hornik, 2012;Pingree & Hawkins, 1996;Rice & Katz, 2001; van Dijk, 2005van Dijk, , 2006Vigdor & Ladd, 2010;Vishwanath et al, 2006), the concept also encompasses psychological factors determining computer use (e.g., Eastin & LaRose, 2000;Han et al, 2009;Ruppel & Rains, 2012;Whitten, Kreps, & Eastin, 2009). Dupagne and Salwen (2005) emphasize the critical public policy debate driving this issue, one defined in terms of disparities in internet access among different social groups.…”

“…Research (e.g., Chakraborty & Bosman, 2005;Ginossar & Nelson, 2010;Hargittai, 2009;Lee, 2009;NTIA, 2010;Pew, 2012;Rice & Katz, 2003;Vigdor & Ladd, 2010) suggests that home Personal Computer (PC) ownership and Internet access are two key challenges defining the digital divide. To the extent that online health applications can enhance preventative healthcare-and even supplement costlier in-person treatment interventions-wider diffusion of online health affordances could help curtail skyrocketing medical costs (e.g., Han et al, 2009).…”

“…That said, only 57% have a high-speed Internet connection (Pew, 2012), as racial and economic divides continue to define digital divides (NTIA, 2010), particularly in e-health domains (Ginossar & Nelson, 2010). Vigdor and Ladd (2010) suggest that a generalized sense of distrust of online technology may be contributing to underutilization of the Internet by some, particularly within disadvantaged and minority communities.…”

Connecting Science and Practice in Child and Adolescent Mental Health Services Research

“…Early attention to stakeholder views, values, and preferences through partnerships hold promise for leveling the field with respect to mental health services in the U.S. The hope is that, when mental health interventions are made more appropriate for target populations, engagement of underserved populations will increase (Ginossar and Nelson 2010;Mance et al 2010). We are in the beginning stages of this work and have yet to see if the promise of researcher-stakeholder partnerships in reducing mental health disparities can be attained.…”