Can mHealth deliver greater health equity?

Who's going to benefit from it? This is the question that gets asked with every new achievement. One concept that is frequently mentioned when talking about digital media in this context is the "digital divide". This term is applied to the gap that exists between the people who are able to use new digital services to expand their knowledge and those who cannot benefit from such progress. Furthermore, mHealth can only benefit people who own the necessary technical equipment, possess the skills needed to use it effectively and have the motivation to adopt it or at least see advantages in adopting it.
Switzerland's Media Use Index for 2017 shows that 92 per cent of the population accesses the Internet from a mobile device. Nevertheless, it must be assumed that there are groups within the population who find using digital media or the content available on them challenging. This group, known as the "digitally disadvantaged", consists primarily of older people and people with a low socio-economic status or level of education.
mHealth skills – i.e. the ability to use mHealth apps effectively – include the following:
– The reading, writing and arithmetic skills needed to use written information.
– Technical skills to ensure access to functioning technical equipment and the Internet, and the ability to use apps, websites or other applications.
– Health skills, i.e. being able to take decisions in everyday life that have a positive impact on health.
– Being able to understand diagrams or
illustrations containing information.

The skills needed to use mHealth apps can change over time and in certain life situations.

Another important consideration is the fact that the skills needed to use mHealth apps can change over time and in certain life situations. The health skills of people with physical or mental problems are frequently impaired in particular situations.
Access to mHealth can be facilitated by improving mHealth skills while at the same time ensuring that the barriers to using mHealth apps are kept as low as possible. mHealth skills can be enhanced by means of smartphone courses or patient empowerment, for example. The most effective way of reducing the barriers to using mHealth apps is to address the issue at the development stage. To enable an app to be used by as many people as possible, for example, the following points should be taken on board: 1. Involve users in the development and evalu-
ation process. 2. Provide action-centred information that addresses the question "What should I do?" 3. Avoid providing too much information. 4. Simple navigation and design. 5. Ensure interactivity: it must be possible to share and print out content.
While mHealth certainly has the potential to increase health equity, it can only do so if it is easy to access, if users have better mHealth skills and if clear data protection regulations are in place.

Literatur:
Graetz et al. (2018): Bridging the Digital Divide: Mobile Access to Personal Health Records Among Patients with Diabetes.
Ahmed, Shameem (2017): mHealth Literacy: characterizing people’s ability to use smartphone based health-related applications.
Kreps, Gary L. (2017): The relevance of health literacy to mHealth.
Broderick, J. et al. (2014): Designing Health Literate Mobile Apps.
Papageorgiou, Achilleas et al. (2018): Security and Privacy Analysis of Mobile Health Applications: The Alarming State
of Practice. Mackert, Michael et al. (2016): Health Literacy and Health Information Technology Adoption: The Potential for a New Digital Divide.