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Research article
Sophie Turnbull
University of Bristol School of Social and Community Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5259-3168
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Type 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity.
Study aims
To gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups.
Methods
A purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically.
Results
A diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender.
Conclusion
This research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.
Keywords
Health inequalities, health equity, digital divide, digital health, ehealth, web interventions, diabetes, chronic conditions
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CURRENT STATUS: Published
View the published article at BMC Public Health.
Version 2
Posted 16 Dec, 2020
No community comments so far
Reviewer #2 agreed
On 09 Dec, 2020
Review #2 received
Received 09 Dec, 2020
Reviewer #1 agreed
On 07 Dec, 2020
Reviewers invited
Invitations sent on 06 Dec, 2020
Editor assigned
On 02 Dec, 2020
Submission checks complete
On 02 Dec, 2020
Editor invited
On 02 Dec, 2020
No comments provided
Editorial decision: Major revision
On 23 Oct, 2020
Review #2 received
Received 12 Oct, 2020
Reviewer #2 agreed
On 24 Sep, 2020
Reviewer #3 agreed
On 24 Sep, 2020
Review #1 received
Received 29 Jul, 2020
Reviewer #1 agreed
On 22 Jun, 2020
Reviewers invited
Invitations sent on 03 Apr, 2020
Editor assigned
On 19 Mar, 2020
Submission checks complete
On 18 Mar, 2020
Editor invited
On 18 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Sophie Turnbull
University of Bristol School of Social and Community Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0001-5259-3168
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
Version 2
Posted 16 Dec, 2020
No community comments so far
Reviewer #2 agreed
On 09 Dec, 2020
Review #2 received
Received 09 Dec, 2020
Reviewer #1 agreed
On 07 Dec, 2020
Reviewers invited
Invitations sent on 06 Dec, 2020
Editor assigned
On 02 Dec, 2020
Submission checks complete
On 02 Dec, 2020
Editor invited
On 02 Dec, 2020
No comments provided
Editorial decision: Major revision
On 23 Oct, 2020
Review #2 received
Received 12 Oct, 2020
Reviewer #2 agreed
On 24 Sep, 2020
Reviewer #3 agreed
On 24 Sep, 2020
Review #1 received
Received 29 Jul, 2020
Reviewer #1 agreed
On 22 Jun, 2020
Reviewers invited
Invitations sent on 03 Apr, 2020
Editor assigned
On 19 Mar, 2020
Submission checks complete
On 18 Mar, 2020
Editor invited
On 18 Mar, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background
Type 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity.
Study aims
To gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups.
Methods
A purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically.
Results
A diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender.
Conclusion
This research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.
This is a list of supplementary files associated with this preprint. Click to download.
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