Closing the digital divide for hemodialysis patients: implementing technology training and support in a digital patient activation intervention.

Abstract

To detail patient challenges, and how technology support addressed them, in a remote patient activation intervention for hemodialysis patients (n = 93) from trained patient mentors (n = 26). Using digital divide theory-derived codes, content analysis of: technology support program delivery data, hemodialysis clinic staff interviews, and support staff reflection papers. Descriptive statistics from postintervention mentee/mentor surveys. All mentees and 46.2% of mentors received support. Motivational access was targeted with explanations, rapport, and support availability. Study-provided, data-capable tablets enhanced material access, but internet access barriers persisted. Skills access was addressed by training; password-related challenges initially dominated. For usage access, on-demand technology support was balanced by engagement support: proactive prementoring session calls and login monitoring. Interventionists should examine internet coverage in targeted areas, potentially using multiple carriers. A balance between password usability and security is required. Engagement support may be needed. Technology support can close patient digital divides.