Promoting Digital Health Equity Among People with Serious Mental Illness

Abstract

As digital technology becomes increasingly integrated into daily life, it is essential to consider how its use influences health and well-being, particularly among individuals with limited access to digital technology, such as those with serious mental illness. The purpose of this research was to examine the relationship between digital technology and health and well-being among people with serious mental illness and to identify ways to promote digital health equity.

This dissertation presents a needs assessment based on community-based participatory methods (Wallerstein et al., 2017). We partnered with a community mental health organization that provides services to people with serious mental illness and assembled an advisory committee consisting of staff members and service users to guide the research process. We conducted four semi-structured focus groups to examine how service users with serious mental illness currently use digital technology, how they would like to use it, and how their use relates to their health and well-being. The focus groups also explored barriers to digital technology use experienced by service users and potential solutions. A pragmatic, mixed inductive-deductive approach to qualitative data analysis was employed. To prioritize barriers and solutions, we used a research method called the nominal group technique that involves assembling a group of experts on a topic and conducting rounds of idea generation, discussion, and idea ranking. We conducted two client nominal groups and one staff nominal group. Ranking data from the nominal groups was summarized and presented descriptively.

Participants described several pathways beyond accessing healthcare through which they believe that service users' digital technology use both positively and negatively impacted their health and well-being. Our findings also provided an in-depth overview of the different barriers to digital technology use experienced by service users and identified several high-priority solutions to explore for intervention development. Existing research largely focuses on digital health equity within the healthcare system. The current research highlights how expanding our conceptualization of digital health equity presents new opportunities to influence health outcomes.