Spanish-Language Consumer Health Information Technology Interventions: A Systematic Review

Abstract

BackgroundAs consumer health information technology (IT) becomes more thoroughly integrated into patient care, it is critical that these tools are appropriate for the diverse patient populations whom they are intended to serve. Cultural differences associated with ethnicity are one aspect of diversity that may play a role in user-technology interactions.ObjectiveOur aim was to evaluate the current scope of consumer health IT interventions targeted to the US Spanish-speaking Latino population and to characterize these interventions in terms of technological attributes, health domains, cultural tailoring, and evaluation metrics.MethodsA narrative synthesis was conducted of existing Spanish-language consumer health IT interventions indexed within health and computer science databases. Database searches were limited to English-language articles published between January 1990 and September 2015. Studies were included if they detailed an assessment of a patient-centered electronic technology intervention targeting health within the US Spanish-speaking Latino population. Included studies were required to have a majority Latino population sample. The following were extracted from articles: first author’s last name, publication year, population characteristics, journal domain, health domain, technology platform and functionality, available languages of intervention, US region, cultural tailoring, intervention delivery location, study design, and evaluation metrics.ResultsWe included 42 studies in the review. Most of the studies were published between 2009 and 2015 and had a majority percentage of female study participants. The mean age of participants ranged from 15 to 68. Interventions most commonly focused on urban population centers and within the western region of the United States. Of articles specifying a technology domain, computer was found to be most common; however, a fairly even distribution across all technologies was noted. Cancer, diabetes, and child, infant, or maternal health were the most common health domains targeted by consumer health IT interventions. More than half of the interventions were culturally tailored. The most frequently used evaluation metric was behavior/attitude change, followed by usability and knowledge retention.ConclusionsThis study characterizes the existing body of research exploring consumer health IT interventions for the US Spanish-speaking Latino population. In doing so, it reveals three primary needs within the field. First, while the increase in studies targeting the Latino population in the last decade is a promising advancement, future research is needed that focuses on Latino subpopulations previously overlooked. Second, preliminary steps have been taken to culturally tailor consumer health IT interventions for the US Spanish-speaking Latino population; however, focus must expand beyond intervention content. Finally, the field should work to promote long-term evaluation of technology efficacy, moving beyond intermediary measures toward measures of health outcomes.

Addressing Barriers to Primary Care Access for Latinos in the U.S.: An Agent-Based Model

“…Even among Latinos living in urban ethnic enclaves-where residents are more likely to share similar cultural norms and beliefs toward Western medicine-those speaking Spanish were less likely to have a regular source of health care (Alcala et al, 2016). To cope with linguistic barriers, different approaches to improve communication quality during health care visits have been developed (Chaet, Morshedi, Wells, Barnes, & Valdez, 2016;Genoff et al, 2016). For instance, a systematic review of cancer screening for patients with LEP found that patient navigation services improved rates of cancer screening by 7%-60% (Genoff et al, 2016).…”

Experientially learning how to communicate science effectively: A case study on decoding science

“…Most of the training was related to teaching graduate STEM student trainees how to appeal to their audience. The workshops addressed audience limitations, abilities, biases, and the importance of researching the audience, segmenting, and tailoring the message to audiences (e.g., Chaet et al, ; Dirmaier et al, ; Takla et al, ; van Lieshout et al, ), as the responsibility for message delivery is on the scientist, not the audience.…”

“…Other issues, such as health literacy, affect message reception, as more than one‐third of U.S. Americans are below an intermediate level of health literacy—meaning, they may not be able to read and comprehend a prescription label without assistance (U.S. Department of Health & Human Services, ). Tailoring messages to audiences based on identity and characteristics, and reasons for accessing information (e.g., Chaet, Morshedi, Wells, Barnes, & Valdez, ; Dirmaier, Härter, & Weymann, ; Takla, Velasco, & Benzler, ; van Lieshout, Huntink, Koetsenruijter, & Wensing, ), often is more effective when appealing to an audience than a generic message (Young, Willis, Stemmle, & Rodgers, ). Studies about science communication training programs have echoed the need for these lessons to be included to achieve programmatic success.…”

Design of a Culturally-Informed Virtual Human for Educating Hispanic Women about Cervical Cancer

“…Virtual agents have been developed to address a variety of health topics, including hospital discharge [4], childhood obesity [19], and mental health [18]. While there has been in an increase in consumer health information technology targeted at the Latino population, the majority of technology-enabled health promotion programs are aimed primarily at educated, health-literate individuals and are not tailored to diverse Latino subpopulations [7, 12]. Novel health communication technologies such as virtual humans that do not rely on advance reading or computer skills have the potential to break down health communication barriers and culturally adapt programs to diverse populations.…”