Table 2.

Common challenges and recommended strategies across underserved population groups

Thematic category	Challenges	Strategies
Individual level
1. Person’s orientation toward health-related needs	Lack of perceived effectiveness of technology in meeting needs Competing health and social needs	Develop health literacy initiatives
2. Person’s orientation toward health-related technology	Preference for in-person care Lack of trust (in technology, health care providers, health system, or privacy protections) Lack of interest in technology	Build accessible, trustworthy privacy policies Enable anonymity Counteract stigma of health-related issues addressed by technology applications
3. Person’s digital literacy	Low self-efficacy in using technology Lack of technology training opportunities	Develop digital literacy training initiatives located in communities Provide easily accessible technical support
Technology level
4. Technology design	Lack of compatibility with other technologies or applications Lack of clarity in operating instructions Lack of inclusive, user-friendly interface Inability to provide input into design Lack of cultural safety Lack of adaptability	Focus on inclusive design or codesign of technologies Ensure cultural, religious, and contextual relevance of technologies Gamification of design Focus on accessible design Ensure compatibility with low-cost devices Ensure interoperability and compatibility with other technologies or applications Enable multiple modalities of communication or interaction Facilitate networks through technology use
Health system level
5. Health system structure and organization	Low health care provider acceptance of technology Lack of health care provider training opportunities Challenges building technology into health care workflows Policy barriers to using technology in health care (eg, privacy policies) Lack of infrastructure Costs of implementation and use	Make connections between technology and other health care programs Make low-technology options to access care available Provide cultural safety training in technology-enabled care Maintain opportunity for in-person care and mixed-modality care Enable direct communication between patients and providers Employ culturally or racially similar providers for communities Financially incentivize health care providers to use technology Fit technology into provider workflows Build opportunities to adapt technology
Social/structural determinants level
6. Social and structural determinants of access to technology-enabled care	Lack of available social support Poor access to internet or cellular connectivity Unaffordable out of pocket costs Systemic racism Inaccessible health care	Employ culturally safe methods of implementation Make high speed Internet access available Make digital devices available