Background: Hospital-at-home care is a viable alternative to traditional inpatient care for older patients, allowing them to remain in the comfort of their own home while receiving hospital level care. The program employ a wide array of wearable smart health device (SHD) to track patient’s vital sign and other health metrics, enabling clinicians to intervene in the real time when complications occur. Despite SHD offers a promising solution to improve care management, less than 4% of SHD users are African American and Latinx. There are a limited number of studies evaluating individual characteristics, like age, gender, ethnicity, and race, and their impact on SHD use. However, these studies provide little guidance on how to intervene and increase SHD use among minority older adults. We aim to identify barriers that prevent the use of SHD among minority older adults through conducting an exploratory interview study.
Methods: An interview study was conducted with 20 English speaking minority older patients (age 60+) who have hypertension and were prescribed a smart blood pressure monitor. Andersen’s Expanded Behavioral Model, which is a culturally sensitive framework for examining predisposing, enabling, and need factors in health service utilization, was used to guide the study. Thematic and classical content analysis are used to identify and quantify dimensions and themes within these factors.
Results: The average age of participants was 70.7 (M = 70.7, SD = 10.3). The majority were African American (n = 19; 95%) and female (n = 11; 55%). The findings revealed that 90% participants experienced device malfunctions and other technical problems, such as issues with device accuracy and portability. 60% participants indicated gaps in knowledge, expressing that they had never heard of SHD before. Also, 35% participants experienced accessibility challenges, such as missing reminder messages. 30% participants were concerned about affordability of the SHD and would only continue using SHD if it remained financially accessible. 20% participants experienced psychological barriers, such as stress and mental load associated with monitoring their health regularly. Lastly, 15% participants experienced physical barriers, like pain and discomfort while using the SHD.
Conclusions: This study highlights the barriers minority older adults have experienced when using SHD to monitor their health. Although SHD adaptation helps expand hospital-at-home care, these barriers could hinder minority older adults’s willingness to use SHD as intended. Identifying these barriers provides a starting point for clinicians to design strategies and collaborate with other health professionals to enhance utilization of SHD among minority older adults while they receive hospital care at home.