Knowledge and smart health device use in racial-ethnic minority older adults with hypertension: a qualitative study

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Background and Objective: Smart health devices (SHDs) can improve hypertension management. Yet, SHD use among racial-ethnic minority older adults remains low, delaying potential benefits and exacerbating health disparities. Knowledge is a key determinant of SHD adoption; however, its influence on SHD use is not well understood. This study examines how knowledge affects SHD use among racial-ethnic minority older adults with hypertension. Research Design and Methods: We conducted an exploratory qualitative study using semi-structured interviews with 20 racial-ethnic minority older patients aged 60+ with hypertension and prescribed a SHD. Thematic and classical content analysis were used to analyze the interview data. Results: Multiple dimensions of knowledge, including prior awareness, sources of information, and gaps in knowledge, were identified as factors in using SHDs. Sixty percent had no knowledge of SHDs prior to being prescribed one. All received education about how to use the SHD from their providers, with many receiving support from others. Gaps in understanding technology, such as how SHDs transmit information, the security of information, and the potential health benefits, were observed. When knowledge gaps were addressed, it resulted in increased SHD utilization as well as improved health behaviors and emotional impacts. Discussion and Implications: Through integrating Critical Race Theory and Andersen's model, this study demonstrates that limited baseline awareness of SHD among racial-ethnic minority older adults is shaped by structural inequities. Provider education and support facilitated SHD engagement. Culturally responsive education, ongoing clinical support, and community-based education are essential to improving SHD utilization and self-monitoring behavior.

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