Digital Health Equity, Empowering At-Risk Communities
HEET Members
Natividad Chen
Patricia Nguyen
Christian Strohm
Tamara Lobban-Jones
External Resources
Chelsea Canlas
Annie Tseng
Completed
2021
Partner Organization
University of California’s CITRIS Health and MITRE ACTIVATE program
Summary
The ACTIVATE program is a community digital health initiative that provides patients with health technology and training to increase access to healthcare services and empower patients to take control of their health. Focused on rural Californian residents, the success of this program rests on increasing digital health literacy in this medically underserved population. To support ACTIVATE, the Health Equity Emissary Team (HEET) of Diverse Health Hub produced explainer animations to educate patients on digital health. The animations were created to be inclusive of the patients’ diverse socio-cultural backgrounds and accessible to low literacy levels.
ACTIVATE launched its pilot program with Livingston Community Health in Merced and Stanislaus counties, which aims to be a blueprint for others throughout the state and nation. HEET designed the animations not only to reach patients, but also to inspire the general public on the potential of digital health to promote health equity.
Introduction
To address high rates of diabetes and hypertension within California’s rural central valley, the Center for Information Technology Research in the Interest of Society (CITRIS) & the Banatao Institute at the University of California launched Accountability, Coordination, and Telehealth in the Valley to Achieve Transformation and Equity (ACTIVATE). This pioneering program is spearheaded by Dr. Katherine Kim, Principal Consumer Health Informatics and Health Scientist at MITRE and Dr. David Lindeman, Director of CITRIS Health, and in partnership with Livingston Community Health. Other ACTIVATE partners include UC Davis Health, UC Davis Center for Reducing Health Disparities, UC Merced, and the UC Merced Health Services Research Institute.
ACTIVATE is a digital health program designed to improve access to quality healthcare for medically underserved populations. First launched at Livingston Community Health in Merced and Stanislaus counties, ACTIVATE is now expanding to other community health centers and developing the tools for broad dissemination across the nation.
By providing both digital health technology and education, the goal of ACTIVATE is to empower patients to learn how to take control of their health and see better health outcomes. Focusing on individuals in California's rural and agricultural central valley, the program provides patients with health technology and teaches them how to measure their own health data and connect to healthcare providers. Depending on their specific needs, participating patients are given phones, tablets and connected health monitoring equipment like glucometers or blood pressure machines. They also receive health education and digital literacy training from health coaches, medical assistants, and community health workers with the appropriate cultural and linguistic skills to engage with the patients.
“Our partnership with the HEET is health equity in motion. It has been a pleasure working with a team that uniquely understands the importance of meeting at-risk communities where they are. The HEET took the time to ensure the audience’s diverse socio-cultural backgrounds and unique needs were part of the story.”
Approach
To successfully integrate digital health into community healthcare, ACTIVATE needs to provide health technology, and ensure the patients understand how to use it. ACTIVATE focuses on the diversity of patients in California rural central valley, including low-income, undocumented, agricultural workers and those with limited English proficiency. Because of these patient demographics, it is especially important to create digital health resources that are inclusive and accessible to this diverse community.
Figure 1. Digital health ball-and-stick network motif
To support this pioneering digital health initiative, the HEET produced a series of explainer animations educating prospective patients on digital health and the ACTIVATE program. The animations aim to educate through warm-hearted, visual storytelling without any confusing medical jargon. Whenever possible, we used visual metaphors to describe abstract concepts in a straightforward, easy-to-understand manner. To explain the concept of digital health, for example, we used a ball-and-stick network motif (Figure 1). The intersecting lines demonstrate the connectivity between different types of digital health technology. We used the same visual metaphor to show how health data measured by the patient is sent to their health provider by illustrating blood pressure and activity levels as icons traveling along a line linking connected devices (Figure 2).
To accurately represent the patient population, the characters were designed to represent patient demographics and be gender, body-size, and age inclusive (Figure 3). The protagonists, Alma and Joseph, are between 38-64 years, are overweight, have darker skin tones, and work in the agricultural industry. Moreover, the healthcare workers depicted in the animations were modelled after the actual healthcare providers serving ACTIVATE participants, Dr. Juan Lopez-Solorza and nurse Rosa Pavey in Livingston Community Health.
To address low English literacy levels and increase accessibility, the animations were produced with both English and Spanish voiceovers, and with language subtitles in English, Spanish, Hmong, and Punjabi.
From start to end, the team considered the audience’s diverse socio-cultural backgrounds and their unique needs to create animations that were as accessible and engaging as possible.
Figure 2. Health data icons travel between connected devices
Figure 3. Characters represent actual patient and healthcare providers
Conclusion
The shift toward digital health is promising from a health equity standpoint. Quality healthcare services can be made available away from physical locations like hospitals, which may not be accessible to medically underserved populations. The technologies that enable patients to monitor their health data and connect them to their healthcare team also empower patients to learn about and manage their own health.
While these technologies help improve access to healthcare for underserved populations, we must ensure that digital health literacy does not create another barrier to equitable care. The WHO Global Strategy on Digital Health advocates for a “people-centered health system” prioritizing educating and engaging patients, families and communities in practices and public awareness of digital health. Clearly, digital health can only be equitable if patients – especially underserved and vulnerable populations – understand what it is and how to use it.
For these reasons, the HEET is honored to support CITRIS and the University of California Berkeley in breaking new ground in the digital health community healthcare space. By educating and empowering residents in rural California to take charge of their own health, the ACTIVATE project aligns with HEET’s mission to address the needs of underserved, diverse health communities, improve health outcomes and increase access to quality care services.
By producing inclusive and accessible explainer animations on digital health, the HEET is also moving the needle forward in promoting health equity and diversity in healthcare communications. HEET designed the animations not only to reach ACTIVATE patients, but also inspire the general public on the potential of digital health to promote health equity. The ACTIVATE program aims to be a blueprint for community-based digital health to support broad dissemination to the state and nation.
Explainer Animation: Introducing ACTIVATE
“By pairing digital health technology with culturally competent digital health literacy resources, ACTIVATE has enormous potential to empower patients to take control of their health and increase access to the healthcare services they need.”
The Health Equity Emissary Team (HEET) works directly with healthcare organizations to build diverse leadership teams, consult on high-level organizational strategy and produce educational content for patients and families. We are an inclusive peer network who spotlights health disparities and improves health outcomes of BIPOC health communities. Please email helloheet@diversehealthhub.org to learn more.
