Primary Submission Category: Health care/services
Racial Differences in the Use of Personal Health Technologies to Improve Shared Decision Making in Healthcare
Authors:Â Fatima Fairfax,
Presenting Author: Fatima Fairfax*
Personal health technology (PHT) can enhance population health and health equity by promoting health behaviors, tracking symptoms, and equipping patients with greater health literacy and agency in clinical encounters. Notably, PHT can improve shared decision making (SDM) between providers and patients, leading to improved healthcare interactions and treatment outcomes. While universally beneficial, PHT has the potential to address healthcare disparities that disproportionately affect marginalized racial groups.
I examine if PHTs influence SDM across racial groups and whether perceived health literacy (PHL) mediates this relationship. Using nationally representative data from the 2022 Health Information National Trends Survey, I apply logistic regression to examine the relationship between two PHTs, wearables and health apps, on SDM for Asian, Black, Hispanic, and white adults. I assess PHL using a measurement model and evaluate its mediating role with path analyses.
In the full population, health apps increase the odds of SDM by 19% at p<0.05, while wearables are only significant at p<0.1. Disaggregated by race, only white patients show increased SDM at the p<0.1 level for both technologies. PHTs were significantly associated with increased odds of PHL among all races, and PHL was associated with increased SDM. This indirect effect through PHL was significant for all races. In contrast, wearables only increased PHL for Asian and white patients, with significant indirect effects on SDM only in these groups.
These findings suggest that PHTs enhance SDM primarily by improving patients’ sense of health literacy, with health apps appearing more universally effective than wearables. The lack of effect of wearables for Black and Hispanic patients is concerning, given their lower rates of positive patient-provider interactions and health outcomes. Further research is needed to address racial disparities in PHT effectiveness and promote health equity.