Journal of the American Medical Informatics Association : JAMIA · 2026
Closing the digital divide for hemodialysis patients: implementing technology training and support in a digital patient activation intervention.
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Veinot Tiffany C, Wickens Megan, Hennessey Edward, Argentina Marissa, Eggebrecht Kara, Zerkle Alicia, Le Vu, Collins Damron Kelli, Velez Lisa, Bragg-Gresham Jennifer, Krein Sarah L, Chatoth Dinesh, Heung Michael, Gillespie Brenda, Murphy Barbara, Zheng Kai, Saran Rajiv
Аннотация
OBJECTIVES: To detail patient challenges, and how technology support addressed them, in a remote patient activation intervention for hemodialysis patients (n = 93) from trained patient mentors (n = 26).
MATERIALS AND METHODS: Using digital divide theory-derived codes, content analysis of: technology support program delivery data, hemodialysis clinic staff interviews, and support staff reflection papers. Descriptive statistics from postintervention mentee/mentor surveys.
RESULTS: All mentees and 46.2% of mentors received support. Motivational access was targeted with explanations, rapport, and support availability. Study-provided, data-capable tablets enhanced material access, but internet access barriers persisted. Skills access was addressed by training; password-related challenges initially dominated. For usage access, on-demand technology support was balanced by engagement support: proactive prementoring session calls and login monitoring.
DISCUSSION: Interventionists should examine internet coverage in targeted areas, potentially using multiple carriers. A balance between password usability and security is required. Engagement support may be needed.
CONCLUSION: Technology support can close patient digital divides.
MATERIALS AND METHODS: Using digital divide theory-derived codes, content analysis of: technology support program delivery data, hemodialysis clinic staff interviews, and support staff reflection papers. Descriptive statistics from postintervention mentee/mentor surveys.
RESULTS: All mentees and 46.2% of mentors received support. Motivational access was targeted with explanations, rapport, and support availability. Study-provided, data-capable tablets enhanced material access, but internet access barriers persisted. Skills access was addressed by training; password-related challenges initially dominated. For usage access, on-demand technology support was balanced by engagement support: proactive prementoring session calls and login monitoring.
DISCUSSION: Interventionists should examine internet coverage in targeted areas, potentially using multiple carriers. A balance between password usability and security is required. Engagement support may be needed.
CONCLUSION: Technology support can close patient digital divides.