Impacts Of Mobile Health Technology on the African American Millennial Health Care Experience.

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Chapter 1

The African American population remain one of the most distressed consumer

groups in health care facing continued hardships related to access and quality of care

(Bowser, 2015). While efforts in the United States continue to focus on health care

utilization frameworks targeting improvements to accessibility and affordability of care,

health care researchers continue to highlight factors that impact the African American

health care experience negatively, including economic stress, emotional stress, race,

American millennials engage with mobile technologies at high rates. Lynn (2016) stated

that among African American millennials, a total of 55% admit to spending at least an

hour every day on social media (this is 11% greater than millennials from other racial

groups), and 91% admit to accessing the internet via smartphones (6% more than other

cultures and races). Considering individuals’ engagement in health care through those

avenues could produce favorable evidence for how the use of mobile health (mHealth)

patient engagement apps affects their health care interaction and utilization behaviors.

The perception of health care in the United States amongst African Americans

influences their experiences in utilizing care. Due to these varying perceptions, it is

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important to explore ways of understanding the lived experiences of African Americans

and their engagements with the health care system. Previous attempts to understand those

experiences have been focused on ensuring health care policies address health access

inequities to improve overall health care experiences for African Americans (Adegboyea,

2016). Policy changes are only part of the solution; therefore, research is also needed on

understanding the day-to-day lived experiences of African Americans and how those

experiences shape their health care reality in the United States.

innovations, like mHealth technologies, can help strengthen the collaborative health

agenda and prove useful for people of color if proper investments are made.

Among those who experience inequitable access to health care, African

Americans experience the steepest roadblocks. Brown et al. (2017) noted that African

Americans make up roughly 13.3% of the U.S. population yet hold a disproportionate

burden of inequitable and/or poor health outcomes, care quality, and treatment results.

The goal of this study was to improve the understanding of the relationship that African

Americans have with the health care system, specifically the ways in which they interact

with it. I had a specific focus on developing a better understanding of the impacts of how

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African American millennials engage with the health care system. The findings can serve

as guidance for developing processes to help the health care community work more

collaboratively with the African American community and identify new opportunities for

strategic engagement focused on bettering this population’s health care experiences using

mHealth patient engagement applications.

Problem Statement

Current literature shows that while efforts are being made to increase the

patient utilization of health care; however, demographics, like age, income, and

geographic regions, impacted the use of these systems negatively (Lyles et al., 2017).

Those socioeconomic and demographic elements were not direct considerations.

People of color, such as African Americans, remain at large a group that

continues to under engage with health care. Among this group, particularly African

American males continue to experience obstacles and barriers that impede access and

utilization to care (Williamson et all., 2019). When addressing the underutilization of

health care, research must expand beyond the core tenants of health care delivery and

focus on uncovering specific correlations between health care technology and its impacts

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on the African American health care experience through evaluating one of the most

active groups of technology consumers in this racial group. Therefore, in this study I

explored the use of patient-facing mHealth patient engagement applications and their

potential impacts on health care utilization amongst African American millennials.

Purpose of the Study

The purpose of this qualitative study was to examine the impacts of mHealth

technology on the health care experiences of African American millennials. Technology

technologies impacts their experiences doing so. It was critical to explore this

phenomenon to fully understand the value of health care in the African American

community who have a long history of disproportionate availability of care. I employed a

phenomenological approach to enhance the understanding of African American

millennials’ perceptions of their use of mHealth technology, access to health care, and

health care utilization.

Research Questions

The following research questions guided this study:

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Research Question 1: What do African American millennials view as potential

barriers to access to care as it relates to their lived experiences and demonstrated

behaviors toward the U.S. health care system?

Research Question 2: In considering predisposed characteristics of the African

American population, what role do technological advancements, such as mobile

health care patient engagement applications, play in African American

millennials’ access to equitable care throughout the U.S. health care system?

utilization and social determinants (Hong et al., 2019). Given that health care engagement

among African Americans is lower than that of other racial groups, the focus of

Andersen’s BM on predisposing characteristics that influence health care utilization may

enable an understanding of how to facilitate African Americans’ engagement in the

health care system (Hong et al., 2019). The Anderson BM has evolved over time to

position its focus on access to care based on the four pillars of potential access, realized

access, equitable access, and inequitable access, with a specific focus on the individual’s

experience with access to care (Hong et al., 2019). The BM aided the current study by

providing a contextual lens through which to view how the behaviors of African

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American millennials shape their experiences with health care in the United States and

how those experiences can contribute to the larger understanding of health care

engagement among the African American population.

A recent Australian use case of Andersen’s BM for evaluating preventive health

care focused the individual as the unit of analysis and extended beyond health care

utilization (Hong et al., 2019). The BM’s pillars of influence helped me directly address

how African American millennials’ perceptions of barriers to health care access and

relationships between the phenomena of interest as it relates to the population of interest

and their life experiences (Ravitch & Carl, 2016). Furthermore, researchers use the

approach when they seek to evaluate and bring meaning to human behaviors and the

factors that dictate such behaviors (Creswell & Poth, 2017). Phenomenological data are

collected by evaluating common traits amongst participants in a study and using those

traits to establish themes and patterns that tell a larger story about the population at large

(Creswell & Poth, 2017).

To begin understanding how mHealth patient engagement application technology

impacts the African American millennial experience, I collected data through surveys of

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African American millennials who had interactions with both the health care system and

mobile technologies. All surveys were completed via Survey Monkey, and written

transcripts of the answers were made available to study participants after they completed

the survey. I coded the participants’ responses using thematic analysis, based Colaizzi’s

phenomenological method of data analysis, to create a holistic, concise understanding of

African American millennial experiences (see Creswell & Poth, 2017). This analytic

approach also helped identify to what extent an enhanced framework for health care

African American millennials: Male and female African American persons born

between the years of 1981 and 1996.

mHealth technologies: Mobile health patient engagement applications available to

consumers to interact with health care providers and the healthcare delivery system

For the purposes of the study, I assumed that all participants were naturalized

and/or U.S. citizens of African American descent based on their admission to attend a

U.S. college or university. At the time of data collection, all responses provided by

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participants were assumed to be truthful and accurate. Accounts of individual

participants’ experiences were perceived as presented, and I did not impose any personal

influence on participants. I have identified these assumptions to provide transparency for

readers of this study.

Scope and Delimitations

I delimited this study to evaluate the health care experiences of African American

millennials. Surveys were conducted with African American individuals born between

phenomenological research design to develop an understanding of the phenomena

through the participants’ firsthand experiences.

The phenomenological research design is used to focus on the lived experiences

of individuals and relies on a small population sample. While the results of this study

provide an understanding of the experiences of a group of people, limitations exist as a

result of generalizations made about the larger population. The results of this study, based

on defined variables, serve as opportunities to expand on in future research. I documented

participants’ experiences as they were detailed by the participants’ survey responses. Any

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personal perspective or experience of my own was bracketed to control the potential

influence on the findings.

Significance

Technology continues to be a driving force in affecting change in the inequitable

delivery of health care models and access to care (Weiss et al., 2018). As technological

tools become more prevalent, eHealth innovations, like mobile technologies, are being

employed to help close gaps of engagement in health care between communities and the

Health care technology innovations are key components to helping improve health

care delivery. This study contributes to social change by highlighting the ability of

technology to empower individuals with information, aiming to increase the population’s

awareness of mHealth patient engagement application technologies. As a force to effect

change, mHealth technologies could be employed to shift the perceptions of health care

across the African American community. My goal with this study was to detail how that

is possible.

Americans, the need for utilizing health care depends heavily on perceived notions,

notions that are too often tied to one’s self-assessment of the seriousness of their illness

(Manuel, 2018).

After the Great Recession, health care use rates remained disproportionate across

the African American population, with African Americans opting to forego health care

more than other racial/ethnic groups (Travers et al., 2017). With the introduction of the

ACA in 2009 and with its expansion in 2011 to extend eligibility for dependent coverage

directly. Travers et al.’s (2017) work on the African American health care experience

built upon Manuel’s (2018) work with both underscoring the need for further

understanding of how and why African Americans experience health care the way they

do.

To enact change in health care utilization across this population, health care data

must be available so that African Americans’ health care interactions are understood.

Ayan et al. (2019) emphasized the importance of patient data completeness to being able

to provide the highest standards of care. If there is little to no engagement with the health

care system, it presents continued challenges to properly develop and implement a secure

engagement strategy for African Americans. Through evaluating racial and ethnic

disparities in health care services, Abdus (2021) evaluated racial minority subgroups and

patient protections existing because of the ACA, finding that racial minority groups, like

African Americans, were disproportionately targeted by coverage provisions presented in

the ACA. This evidence shows that opportunities exist to narrow racial/ethnic disparities

in health care delivery.

Socioeconomic Aspects of Health

landscape toward a more equitable state. Assari (2018) argued that reducing health care

disparities calls for a multitiered approach that can span various system levels while

expanding its reach geographically. Furthermore, the geographical availability of health

services is identified as a critical factor in accessing quality care. It is critical to focus on

these factors in the context of technology use amongst African American millennials to

understand how this might impact their health care experiences due to the continuing

concerns about the correlation between socioeconomic levels and inequality.

Socioeconomic inequities place economic inequalities as a key driver that creates

barriers to accessing health care services. Galea and Vaughan (2019) supported this

thought, stating that when determining a central foundational cause of health care

inequity and promoting better access to health care, both an economic perspective and a

basis of proximal causes can be used, which is relevant to understanding how the

behaviors and exposures of the African American population contribute to their

experiences with the health care system.

Low socioeconomic status is most prevalent among Black populations and has

been linked to a broad scope of health care-related outcomes for this population (Popescu

discussions during the transition from fee-for-service, perceptions of healthcare from

both patients and providers affect how care is accessed. According to Arpey et al. (2017),

due to varying levels of effect, the ways in which critical stakeholders step in to address

inequities must encompass a multifaceted approach, targeting both providers and patients

as part of the health care system.

Health Information Technology and Patient Engagement

Health information technology (HIT) can be leveraged as a vital component of

advancing the patient engagement health care strategy. Experts have shown patient

engagement is a contributing factor to improving health outcomes; however, as a concept,

it is not well understood or positioned (Higgins et al., 2017). Being able to understand the

connection between HIT and patient engagement helps to frame ways the health care

arena can focus on using key elements of health care engagement to advance the

discipline of care. Long et al. (2016) noted that the intersection of HIT and patient

engagement is complex due to factors, like sluggish adoption HIT rates, lack of

interoperability across several HIT systems, and health care providers’ unwillingness to

fully engage with these systems and augment existing workflows to fully engage patient

must be made to engage patients by ensuring technologies, like mobile patient

engagement tools, are targeting the intended populations. To fully understand the impacts

of HIT and how to promote meaningful use of this new era of technology, patients remain

of critical importance. The promises of HIT for improving the continuum of care are not

yet fully realized. Rief et al. summarized that with the use of mobile health technologies,

patients are enabled to move past barriers due to a sense of self-engagement based on the

use of text-text secure communication and the readily available access to their

information or provider when needed. This led to patients being more proactive about

educating themselves about their need for health care engagement.

In a recent study, Han and Lee (2018) made note that among several recent

studies on patient engagement, more than 80% reported increased patient engagement

levels in varying degrees in response to health information technology. While mHealth

technology continues to be positioned, innovators and adopters are also aware of its

limitations. These limitations exist in areas like stability with infrastructure and

scalability, cost of acquisition, and most notably security management; an innovator or

consumer's ability to properly secure transmission of data in flight and at rest (Han &

their abilities to utilize health care, exploring the feasibility to reduce health care

disparities using mobile technology. Ratwani et al. (2019) also focused on these

sensitivities by identifying a need for all health care professionals, administrators,

consumers, and policymakers alike, to focus on the patient-provider relationship.

Commonly, perceptions, access, and utilization of care across the African American

population are noted disparities due to the lack of attention and priority placed on them

by the system. Both Ray et al. and Ratwani et al. place emphasis on the experiences of

African Americans from both a societal and cultural aspect requesting a need for health

care stakeholders to competently address the lack of healthcare engagement in this

population.

McCloud et al. (2016) highlighted the importance of healthcare access and equity

through a digital framework, focusing on a consumer-centric framework of healthcare

resilience. In the late 1990s, gaps in access to digital health were more widespread across

racial groups in comparison to Whites. With African American millennials being the

leading group to access the internet via mobile phones, this helped highlight opportunities

encounters with the U.S. healthcare system if innovative strategies of engagement are not

inclusive. As a shift in healthcare to value-based from fee-based, strong consideration

must be given to how this impacts people of all socioeconomic classes. There remains a

dichotomy in the 21st century where the health of populations varies significantly

specifically in minority populations. Bor et al. (2017) noted that without a significant

change in reducing inequalities across socioeconomic classes, inequitable access to care

will become more widespread and health poverty will harden for minority populations.

As a level of engagement, technological innovations like mobile technologies are

referenced as a possible means to address the gap.

Yee et al. (2018) provided insight on the advances in health care and their

improvements in the healthcare delivery system noting specifically that a challenge

remains in achieving the best outcomes for individuals. Beyond the general scope of

enhancing the delivery system, they highlighted an ability to improve health care

inequities by leveraging health care technologies to deliver equal access to health care

regardless of social and geographical inequities. At the forefront of this result, the focus

remains on considering the context and experiences of patient perspectives for these

Jenseen et al. (2016) noted in their research, patient attitudes continue to shift towards

more real-time methods of interacting with the health care system through things like

mobile technologies, online social media platforms, and the like. To what extent African

Americans, specifically millennials intend to leverage these methods is not yet fully

understood. What we know based on the evidence, is that due to factors like low

socioeconomic status and race and ethnicity, minority groups like African Americans are

likely to support these technology approaches because they view them as savvy ways of

staying relevant with what is new and hot (Jensen et al., 2016).

Innovative ways to leverage healthcare technology is an essential approach that

Ray et al. (2017) brought to focus in their research. Most importantly, as it pertains to

minority groups leveraging mobile technologies, it is coined as an effective tool to garner

engagement from racial minority groups. As a racial group with high rates of engaging

with technology, there is a high probability of reliance on using mobile technologies as a

go-to source for information. Ray et al. further detail that while this may be true, health

care policy must support the expansion of technologies for this purpose. It is the pure

lines. Championing diverse but inclusive uses of health care technology is the area of

focus that Pierce wants to ensure all stakeholders consider in using technologies to

positively create change in how racial minority groups engage with health care in the

U.S..

Commonly, existing literature highlights the continued need to bridge the access

and health information divide, pointing to mobile technologies as a key conduit to deliver

readily available information to patients quickly. It is well known that African American

communities often reside in geographical areas that are economically and geographically

disadvantaged, a direct barrier to quality and accessible health care. Ray et al. (2017)

continued to push the theme that while many in these populations are limited in their

abilities to mobilize, that technology reaches beyond barriers like that.

Researchers continuously evaluate the phenomenon of the utilization of care

based on things like organizational influences in the health care space. This furthers the

evaluation of healthcare space dynamics and continued elements that impact its’

availability and accessibility. Norton et al. (2019) explained that the adoption of

advanced (HIT) is variable but effective. Furthering the thought that in order to

Nelson (2018) detailed in their work that improving health care through a digital

connection is paramount to the success of equitable access to care. They point out that

among health care consumers many overwhelmingly look to mobile access to technology

that will allow them access to health data, rely on various means of online access to seek

information, and continuously look for more nontraditional ways to interact and consult

with health care providers.

Arguments exist among some health care industry stakeholders that patients in

some cases are disempowered by commercialized digital health information technology.

Eberling et al. 2019) made note that while legislation exists to help advance the reach of

health care technology, in some cases potential benefits are tainted by corporate interests.

Eberling et al. referred to the relationship between the healthcare industry and policy

stakeholders as sociopolitical power. Consumers should have total control over how they

engage with the health care system, how patient data are used, and options to choose the

best care based on its value. In many instances, we still see the impact of socioeconomic

factors that continue to cause layers of difficulty for racial minority groups like African

Americans.

Americans specifically, health literacy rates are historically disproportionate due to

discriminatory health policies and systemic healthcare practices which resulted in

limiting access to resources and skills needed to fully understand health information. As a

limiting factor, scholars and legislators alike must be certain to address this as a catalyst

to increasing the use of mHealth technology in African American populations.

Socioeconomic factors and cultural and geographical elements exist as barriers to

engagement for African Americans. For this reason, exploring the utilization of

healthcare in relation to mHealth technology is sensible. Both McCloud et al. (2016) and

Lyles et al. (2016) understand that to effect change, stakeholders need to better

regarding the proposed survey allowed for the construction of the formal survey for

distribution to potential research participants. I collected all survey responses via Survey

Monkey and used NVivo to analyze the data (see Appendix).

Pilot Study

For purposes of testing the proposed research instrument, I used industry

colleagues and college friends to test out the feasibility and acceptability of both the

survey distribution methods and willingness to answer questions. Procedures for

Data Analysis Plan

At the conclusion of participant survey sessions, I analyzed all survey responses

using NVivo. A word-based strategy was used to identify themes through evaluating the

frequency of words used repetitively and once identifying the terms, further evaluating

them based on the context in which they were used. This approach helped create a well-

rounded perspective of the respondents’ points of view. Data were collected over a 3-

month period.

With the use of NVivo, I documented the comprehensive themes as they existed

across the respondent data. These themes were then expanded to detail how participants

experienced the phenomenon, and based on these results, I made the determination to not

reengage with participants because data saturation was achieved.

Issues of Trustworthiness

The outcome of a research initiative should result in valid outcomes. The

qualitative approach to research relies on an investigative style to understanding a

phenomenon and collecting data (Creswell & Poth, 2017). As such, phenomenological

studies rely heavily on the trustworthiness of the participants. I employed selective

themes derived from the study using NVivo. Peer debriefing created an opportunity for

collecting additional views into my analysis of participants’ responses.

As the researcher, I had the responsibility to ensure the participants involved and

the research process employed were thoroughly described. Creswell and Poth (2017)

stated that detailed accounts of individuals’ experiences of a phenomenon help to achieve

transferability. To manage transferability, I provided a rich account of the descriptive

data, including the health care experiences of African American millennials, their

interactions with mHealth technology, and their perceptions of its impact on their overall

health care experience, as part of this study.

Employing an external auditor provides unique accountability in that the auditor

has no true familiarity with the research and offers an objective analysis of its’

dependability (Creswell & Poth, 2017). In qualitative research, dependability refers to

reliability (Creswell & Poth, 2017). I used an external auditor to secure the dependability

of the data. Two former colleagues who were previous Institutional Review Board (IRB)

health care study reviewers were secured as auditors for this research.

The strategy of reflexivity accounts for explicit awareness of bias that a researcher

University requires that the researcher’s plan for research be reviewed and approved by

the IRB. My proposal for this study was presented to the Walden University IRB and

approved before I began collecting data. The IRB approval number is 10-23-20-0406642.

To take part in the research, I presented participant with a consent form to complete that

detailed the purpose of the study, participant selection criteria, and what the data

collected from their survey would be used for. Before starting the survey, all participants

reviewed a message that stated their participation in this survey was voluntary and

represented their consent for their responses to be used as part of data collection. Users

had the option to accept or not accept participation in the survey by selecting the

appropriate answer: to proceed or not to proceed.

Creswell and Poth (2017) stated that there was the need for researchers to protect

their participants by working to establish trust and providing a conducive environment for

participants to share their experiences. To ensure participant privacy, all participants were

informed prior to proceeding with the survey that the survey was anonymous and that any

details possibly identifying participants would not be shared in the results. To further

The levels of health care engagement and utilization in the African American

community continue to cause negative effects (Ayan et al., 2019). As a community with

an engaged millennial population, there remains evidence that significant gaps in care

still exist despite strategic maneuvers to increase access and affordability to care (Ayan et

al., 2019). Health care researchers must begin to fully understand the African American

millennial health care experience to create effective change throughout the entire

population. In this study, I explored the use of patient-facing mHealth applications and

their impacts on the health care utilization of African American millennials.

Chapter 4 focuses on study design, data collection and presentation of results for

the study.

Chapter 4: Results

I selected the phenomenological approach so that individual participant

experiences could be understood to uncover how health care stakeholders and experts

need to refocus on engaging with African Americans age of health care post ACA in the

U.S. The following research questions guided this study:

Research Question 1: What do African American millennials view as potential

barriers to access to care as it relates to their lived experiences and demonstrated

the health care experiences of African Americans. In Chapter 4, I present the results and

findings of this study.

Pilot Study

The pilot study did not have any impact on the main study. As noted in Chapter 3,

I did not focus on assessing participant responses to the survey questions in the pilot

study but rather on the response rate to questions to assess any need for question

restructure. The pilot study did not result in any changes in instrumentation or data

analysis strategies.

Setting

There were not any direct conditions that influenced participant responses to the

survey questions. I used a single qualitative research data collection method: surveys.

Surveys were created using SurveyMonkey and the social media platform Facebook was

used to garner participant interest. This approach to participant recruitment allowed for a

vast participant pool of which only 16 participants were needed to achieve data

saturation.

Survey Demographic Details

on Facebook. In Chapter 3, I explained that my initial intent was to leverage the use of

the Walden Participant Pool but due to a lack of participant response, a request was

submitted to and approved by the Walden University IRB to update my data collection

methods. This allowed for access to a larger population from which to secure potential

research participants. Once research participants selected the option to participate in the

survey, they were redirected to the survey hosted on Survey Monkey and presented with

eligibility and consent criteria. The eligibility criteria included: (a) being an African

American born between 1981 and 1996; b) being engaged with the U.S. health care

delivery system within the past 6 months to 1 year. Their participation in the survey

themes emerge from data analysis: (a) accessibility to health care services, (b) range in

motivation for seeking health care services, and (c) mobile application use. Each theme is

discussed in the Results section in relation to the research questions.

Evidence of Trustworthiness

I employed selective strategies to establish evidence of trustworthiness in the

study. The concepts of credibility, transferability, dependability, and confirmability were

achieved in helping to provide evidence of trustworthy data. Strategies for each of these

concepts were not adjusted based on the original plan as presented in Chapter 3.

All participants displayed a desire to answer all questions in the survey. This

helped to demonstrate that the questions asked in the survey were credible and valid. To

establish credibility, I used triangulation and peer debriefing. Triangulation allowed me

to reference existing literature and identify codes to evaluate themes derived from data

analysis using NVivo. Peer debriefing created an opportunity for adding additional

perspectives when analyzing the participant survey responses. As comments emerged

from the data analysis, these credibility strategies helped to validate the qualitative

of its impact on their overall health care experience as part of the results of this study.

Employing an external auditor provided unique accountability in that the auditor

had no true familiarity with the research and offers an objective analysis of its’

dependability (Creswell & Poth, 2017). In qualitative research, dependability refers to

reliability (Creswell & Poth, 2017). I used an external auditor to secure the dependability

of the data in the study. Two former colleagues who were previous IRB health care study

reviewers were secured as auditors for this research.

The strategy of reflexivity accounts for explicit awareness of bias that a researcher

may have while completing the study (Creswell & Poth, 2017). Confirmability aims to

ensure participants are truthful and genuine (Creswell & Poth, 2017). Using this

qualitative approach to gather data required that participants’ answers to the survey

questions posed were representative of their true experiences.

Results

Research Question 1 Analysis and Results

Theme 1: Accessibility to Health Care Services

While health care services might be available across the United States, the ability

Participant Responses: Accessibility to Health Care Services

Participant

Participants comments

Khumalo et al. (2021) suggested that negative perceptions, attitudes, and lack of

The results suggest that perspectives of participants help bring understanding to

how mHealth technology can be considered as part of the African American health care

experience. It helped illustrate how everyday interactions with the health care delivery

space help to shape how African Americans decide to engage, used, and leveraged health

care in the United States. It also helped to uncover areas of opportunity that can be

targeted for improvement. Chapter 5 integrates the components of this dissertation,

Chapter 5: Discussion, Conclusions, and Recommendations

The purpose of this qualitative study was to examine the impacts of mHealth

technology on the health care experiences of African American millennials. I conducted

this study to develop a better understanding regarding the influences of health care

utilization amongst African American millennials.

Interpretation of Findings

The study findings consist of three major themes as a critical means to impact

ways of delivering care.

The study findings also indicate that while there is great anticipation of long-term

benefits of mHealth technologies, years of inequitable access to, delivery and, cost of

care still negatively impact how African American millennials and their communities still

perceive the U.S. health care system. To that point, scholars, practitioners, and health

care leaders alike should employ themes from this study to assess ways to create new and

adjust existing strategies to leverage the use of mHealth technology to change the

narrative and perceptions of health care in communities of color as well as the ways in

which care is managed and delivered.

Limitations of the Study

The phenomenological approach to research focuses on the lived experiences of

individuals and relies on a small population sample. While the results of this study

provide an understanding of the experience of a group of people, limitations exist because

of generalizations made about the larger population. The results of this study, based on

defined variables, serve as opportunities for expansion in future research. I documented

participants’ experiences as they were detailed the participant survey responses. Any

subset of the African American population (i.e., African American millennials) by

evaluating it at-large based on identified themes.

Another recommendation is for future researchers to expand the sample size of

African American millennials. While the phenomenological approach to research allows

for generalizations, additional study participants could provide further analysis and

possibly reinforcing themes already identified or uncovering additional themes.

I also recommend diversifying the sample population. A future researcher could

sample the existing population but also include a different age group as an additional

sample population, which would help to provide more real-time insights into how diverse

groups within a population may have different lived experiences as it relates to the

impacts of mHealth technologies.

Another recommendation is to evaluate the use of mHealth technologies in

majority populations and compare the findings against patterns of competence and use in

the African American millennial population. While African American millennials and

most populations have similar mobile app awareness and use patterns, having direct

evidence to compare how mHealth technology impacts their health care experience

development. The patient experience begins at home, so understanding the lived

experiences of African Americans at home would help to orient the patient to be more

receptive when interacting with the U.S. health care system (see Hawkins & Mitchell,

2018).

Health care leaders and change agents need to explore how they can further

motivate African American millennials and, more importantly, their communities at large

about the importance of health care utilization and the critical role that mHealth

technology can play in their lives. This is an important influencing phenomenon to

understand because for too long, the systematic framework of health care delivery has

impeded African Americans’ willingness to engage with the health care system. Simply

put, behaviors learned from generation to generation can no longer be the standard and

can no longer be dismissed by the health care community.

A modeling approach to health care delivery based on the adoption of mHealth

technologies can meet African American millennials where they are. Bettiga et al. (2020)

noted that smart technologies are emerging, new instruments in the health care space that

can serve as change agents by encouraging citizens’ acceptance and willingness to

grassroots approach to deploying mHealth technologies might gain traction and have a

higher probability of securing and increasing patient engagement.

The results of this study could be disseminated in written form, whether through

publication, seminars, conferences, or focused training forums. Strategies for leveraging

mHealth technologies to enhance care delivery models are ever-present now, but health

care leaders can certainly pay closer attention to the social welfare of African American

communities such that delivery is more tailored and specific to their needs.

In conclusion, the results of this study may be valuable to both African American

millennials and their communities as well as leaders working in the health care field. To

provide a comprehensive, equitable, and cost-friendly health care experience, industry

strategies must exist and align in a manner that addresses and meets a patient where they

are. There is no one-size-fits-all solution that can adequately provide care for all patients.

When seeking care, African American millennials and their communities must begin to

think differently and be open to a new way of engaging with the health care system.

Health care delivery in the United States aims to be transformative. With ongoing

American community.

In an effort to shift from volume-based care to value-based care, the health care

delivery system will need to place a specific focus on how various populations engage

with, interact with, and utilize healthcare services. Nelson and Potter (2020) noted that

this systemic shift needs to focus on implementing strategies that facilitate quality and

continuity of care as well as cost effectiveness.

The use of technology can be expanded to address these elements of health care

delivery across the African American population. Health care leaders must fully evaluate

and understand the use patterns of African American millennials as it relates to mHealth

technology. Technology reaches beyond physical walls by creating the ability to put

health care tools in the patient’s hand through mobile engagement technologies and by

continuing to create teaching and learning opportunities by highlighting the importance

of health care technology. That knowledge can enhance and inform better patient-

provider relationships and be leveraged to expand strategies to address the African

American community at large. The social aspect of this finding cannot be understated.

In addition, this study clarified African American millennials’ utilization of the

Technology dictates many experiences that would not have existed prior. More

importantly, it continues to be introduced to the health care space, providing an

opportunity to create a more comprehensive approach to delivering and experiencing

care. In this study, I aimed to provide an understanding of African American millennials’

utilization of the health care system and how the use of mHealth technologies impacts

their experiences when utilizing health care services. To explore that phenomenon, I

conducted surveys as the sole data collection tool and used NVivo to analyze the

collected data and determine common themes. The study resulted in three common

themes: (a) accessibility to health care services, (b) range in motivation for seeking health

care services, and (c) mobile application use. With the findings of this study, health care

leaders and change agents can explore patterns of use and social awareness of mHealth

application technologies in African American communities to create and enhance

strategic health care delivery models and frameworks to improve the use of health

services amongst this population.

As a result, the potential for social change is unlimited. Considering health care

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