Identifying Skill and Usability Barriers to Digital Health Tool Use Among Older Adult Patients in US Safety Net Clinics: Mixed Methods Study

Taylor Rapson   ^{1, 2} , PhD ;   Magaly Ramirez   ¹ , PhD ;   Sandy He   ² , BS ;   Jeanette Wong   ^{2, 3} , BS ;   Hyunjin Cindy Kim   ^{2, 3} , MPH ;   Isabel Luna   ^{2, 3} , BA ;   Andersen Yang   ^{2, 3} , MPH ;   Junhong Li   ^{2, 3} , BS ;   Paul A Fishman   ¹ , PhD ;   James D Ralston   ^{1, 4} , MPH, MD ;   Courtney R Lyles   ^{2, 3, 5 *} , PhD ;   Elaine C Khoong   ^{2, 3, 6 *} , MS, MD

¹ Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, United States

² Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States

³ Action Research Center for Health, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States

⁴ Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States

⁵ Center for Healthcare Policy and Research, University of California at Davis, Sacramento, CA, United States

⁶ Division of Clinical Informatics and Digital Transformation (DoC-IT), Department of Medicine, University of California, San Francisco, San Francisco, CA, United States

*these authors contributed equally