Multilevel barriers to digital health technology use among village health volunteers in Thailand: a mixed-methods study in a peri-urban setting

Information from the abstract

Digital health technologies are increasingly used to support primary healthcare delivery, health information management, and community-based health services. In Thailand, village health volunteers (VHVs) serve as frontline community health workers who contribute to community health promotion and digital health-related activities. However, perceived barriers affecting the use of digital health technologies among VHVs remain insufficiently understood, particularly in peri-urban community health settings where digital infrastructure, user capacity, and organizational support may vary. This study aimed to identify perceived barriers to digital health technology use (DHTU) among VHVs and explore multilevel factors influencing these barriers using a mixed-methods approach. A convergent mixed-methods study was conducted among VHVs in a peri-urban province in Thailand. Quantitative data were collected using a structured survey administered to 840 VHVs to assess demographic characteristics, digital communication competencies, and perceived barriers to DHTU. Descriptive statistics were used to summarize participant characteristics and reported barriers. Qualitative data were obtained through in-depth interviews with selected VHVs to explore experiences and contextual factors influencing digital health technology use. Qualitative data were analyzed using thematic analysis. Quantitative and qualitative findings were integrated using a mixed-methods joint display approach to identify multilevel barriers to DHTU. The most frequently reported barriers to DHTU included lack of technological skills (36.79%), absence of user manuals (36.17%), limited understanding of data security (27.66%), difficulty using applications (25.24%), and insufficient training (23.35%). Additional barriers included lack of funding (19.62%), unclear policies (16.55%), and time limitations due to workload (14.62%). Qualitative findings identified six key themes: limited digital skills, application usability challenges, lack of structured training, time constraints, limited data security literacy, and financial barriers. Integration of quantitative and qualitative findings indicated that barriers to DHTU operate across individual, system, and organizational levels. Barriers to DHTU among VHVs extend beyond technical skill deficits and reflect interconnected challenges related to digital literacy, system usability, training support, and organizational resources. Strengthening competency-based digital training, improving user-centered system design, and enhancing institutional support mechanisms may facilitate more effective integration of digital health technologies in community-based primary healthcare systems. Not applicable.

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Related topics: ICT in Developing Communities · Telemedicine and Telehealth Implementation · Mobile Health and mHealth Applications