Digital health implementation among older adults: health technology navigators' perspectives.

Objectives: Despite the rise in health technology, a persistent digital divide affects underserved groups, including low-income, uninsured or underinsured, and limited English proficient (LEP) patients. This study highlights lessons learned from a unique stakeholder-health technology navigators-about factors affecting digital health use among older and linguistically diverse patients in one of the largest US safety-net health systems.

Study design: We conducted in-depth interviews with Los Angeles County Department of Health Services (LAC DHS) navigators from June to December 2023. Discussions focused on their job role, identity, experiences supporting older patients (≥ 50 years) to register and use the patient portal, and linguistically diverse patients (primary language other than English or LEP) in this safety net.

Methods: We used the Theoretical Domains Framework to create an interview guide. We interviewed 9 female and 2 male navigators across 9 LAC DHS clinics who were bilingual (English and Spanish). Interviews were transcribed and analyzed for major themes.

Results: Three primary themes emerged from the qualitative analysis: characteristics of a successful navigator, patients' prior experiences with digital health, and barriers in the clinic.

Conclusions: Navigators highlighted older patients' interest in learning to use digital tools and the need for support in digital health engagement. In describing their work with patients, navigators drew on their lived experiences with family and community to connect with these older patients in the Los Angeles safety-net health system. The lessons learned from these navigators can inform digital health engagement in other safety-net health settings so that they are more inclusive for older patients.