||<p>Background: Digital divide among elderly people is an emerging problem. With more
adoption of technology in the health care field, we should be aware of the health
inequity generated by the adoption of digital health as the norm after COVID-19 crisis.
Objectives: The primary aim of this study is to evaluate the participants’ comfort
with technology (self-reported digital literacy) prior to using VERA, a digital health
platform for exercise therapy. The secondary aim is to examine the association of
patient characteristics and digital literacy with the acceptability, treatment adherence,
accuracy of exercises performed, and change in exercise over 90-day intervention.
Methods: This cohort study used secondary data from the VERITAS clinical trial (clinicaltrials.gov
identifier: NCT02914210). The research analyzed socio-demographics, digital health
determinants, and process outcomes at 90-days. Descriptive statistics were conducted,
Prevalence Ratio (PR) was used as a measure of association.
Results: Participants who were older in age and had less than 16 years of education
were less comfortable with technology. Less comfort with technology prior to starting
therapy was not associated with lower acceptability, adherence, accuracy, nor change
in days per week exercised over 90 days. We found that having a preexisting condition
of neurological disorders was associated with lower self-reported adherence.
Conclusion: Age and education are related to comfort using technology. We should take
them into consideration at the digital health design stage. Besides, we didn’t find
unequal use of VERA with the process outcomes among different strata, which means
by personalized health intervention and improved usability, people who have disadvantages
can also adopt technology to achieve better health. By advocating the human-centered
design, digital health can benefit more people to achieve health equity on a large