Digital Inclusion, Access, and Literacy

Digital health tools (e.g., patient portals, telehealth, mobile health applications) are increasingly essential to meaningful engagement in healthcare. These tools facilitate access (e.g., patient-provider communication, remote visits) and self-management (e.g., engagement with health information) and are associated with greater patient satisfaction, better chronic disease and behavioral health outcomes, and reduced acute care utilization. Providing personalized support may increase engagement among patients who face challenges to using digital health tools, but it is difficult to identify patients who require assistance with digital health due to the dearth of validated screening measure that are usable in a clinical setting, particularly screening tools tailored for use among patients in safety net settings at greater risk for facing digital exclusion (e.g., older adults).<br><br>The purpose of this study was to identify a brief set of measures to efficiently and accurately measure digital skills to identify and tailor approaches to support patients requiring assistance to effectively use digital health tools. The objectives were to: (1) Develop a short self-report measure (Skills Measurement and Readiness Training for Digital Health [SMART Digital Health] Scale) of digital skills needed to use digital health tools, and (2) validate the SMART Digital Health Scale in relation to observed performance completing digital health tasks among a diverse sample of patients receiving care from safety net healthcare settings.

数字健康工具（例如患者门户、远程医疗、移动健康应用程序）在实现有意义的医疗保健参与方面正变得愈发不可或缺。此类工具可助力患者获取医疗资源（如医患沟通、远程问诊）与开展自我健康管理（如查阅健康信息），并与更高的患者满意度、更优的慢性病与行为健康结局，以及更低的急诊医疗资源使用率相关。为使用数字健康工具存在困难的患者提供个性化支持，或可提升其参与度，但由于缺乏可在临床场景中使用的经过验证的筛查工具，尤其是针对更易面临数字排斥风险的安全网医疗服务机构内患者（如老年人群）定制的筛查工具，因此难以识别出需要数字健康相关协助的患者。

本研究旨在开发一套简短的测评工具，以高效且精准地评估数字技能水平，从而识别出需要协助以有效使用数字健康工具的患者，并据此制定针对性支持方案。本研究的目标为：(1) 开发一款针对使用数字健康工具所需数字技能的简短自评量表——数字健康技能测评与就绪培训（Skills Measurement and Readiness Training for Digital Health, SMART Digital Health）量表；(2) 在来自安全网医疗服务机构的多类患者样本中，以患者完成数字健康任务的实际表现为效标，对该SMART数字健康量表进行效度验证。