National Centre for Remote and Rural Health and Care: Information Hub

Hepburn, Jennifer (2023 – 2029) Optimising Equitable Delivery of Digital Health to Older Adults with Chronic Disease in Rural Scotland, Strathclyde University

Supervised by: Dr Lynn Williams and Dr Lisa McCann

The PhD is fully funded by the generous donation of Leslie Stretch.

Contact for Queries: Jennifer.hepburn@strath.ac.uk

Although those in rural areas have the most to benefit from digital health technology, they are less likely to use it, and it is important to understand why this is. Rural locations also have disproportionately higher rates of chronic disease and a higher proportion of elderly adults. Many patients must travel long distances to access healthcare services and are often reliant on public transport. There are also issues with retention and recruitment in rural primary care. Digital health technology has the potential to overcome some of these barriers but we need a better understanding of the barriers and facilitators faced by patients and healthcare professionals working in rural areas.

This PhD thesis will explore the barriers and facilitators to digital health technology adoption among older adults with chronic disease. The first stage will involve an update and extension of an existing systematic review (Bertolazzi et al 2024) to include grey literature. The review will aim to identify any differences in barriers and facilitators for those living in rural compared to urban areas. The review will also examine the role that co-design plays in facilitating the adoption of technology by these patients. The protocol for the review is available on Prospero: Registration: CRD42024586893.

The initial findings from the review suggest that there is a lack of standardisation in reporting participant information in digital health research and no agreed definition of rurality, which makes comparisons between rural and urban findings difficult. The studies in the review demonstrate the importance of the healthcare professional role; both as a barrier and facilitator to the uptake of digital health technology.

The next stage will be to seek the views of patients and healthcare professionals living and working in remote and rural Scotland and give them a voice which is currently missing from digital health research through qualitative interviews (and potentially quantitative surveys).