Publication Date



knowledge, practices, safety-net patients, mobile health promotion, telehealth, smartphone


Purpose: Mobile health technology (mHealth) can reduce health disparities, but research on the health behaviors of low-income patients is needed. This study evaluates mHealth knowledge and practices of low-resource safety-net patients.

Methods: We administered a 47-item questionnaire to 164 low-income patients accessing services at community health centers in the state of Washington and Washington, DC. Predictor variables included demographic factors: age, race, ethnicity, income. Outcome variables were smartphone knowledge (smartphones as a wellness tool), medical app knowledge (availability of medical-based apps), smartphone practices (ever used smartphones for wellness), health apps practices (ever used health-based apps), and medical apps practices (ever used medical-based apps). Multivariate logistic regression assessed relationships between predictor and outcome variables.

Results: Mean age was 35.2 years (median: 34), and study cohort (N = 159) consisted of mostly women (68%), white race (36%), and income of < $20,000/year (63%). Outcomes: 71% and 58% reported knowledge of using smartphones for wellness and knowledge of medical apps, respectively; 76% used smartphones for wellness, with adults 50+ years of age significantly less likely than younger adults (odds ratio [OR]: 0.94, 95% confidence interval [CI]: 0.88–0.99); 48% used health apps, with adults 50+ years of age less likely than younger adults (OR: 0.95, 95% CI: 0.91–0.99) and respondents earning < $20,000/year less likely than higher earners (OR: 3.13, 95% CI: 1.02–9.57); and 58% used medical apps, with Hispanics/Latinos significantly more likely than non-Hispanics/Latinos (OR: 6.38, 95% CI: 1.04–39.02).

Conclusions: Safety-net patients use mobile devices for health promotion. Age and income are important predictive factors, suggesting a more tailored design of the technology is required for broad engagement and health equity.




January 24th, 2018


April 13th, 2018


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