Connect with Tech Program Details

Introduction

The COVID-19 crisis has highlighted structural health disparities and health inequities in the United States, specifically in rural and low-resourced communities. Research has demonstrated that Americans living in rural areas face specific health risk factors, including geographical isolation from healthcare facilities, physician shortages, higher rates of poverty, lack of access to health insurance, etc. Additionally, rural areas tend to have a larger aging population than urban areas, which leads to unique risks faced by this population. In Pennsylvania, the number of older adults is set to increase exponentially, and those in rural counties in PA face significant risk factors and barriers when accessing healthcare exacerbated by COVID-19.  

Accessing the internet, especially since most healthcare providers switched to telehealth services during the pandemic, is one way to enhance health. A report from Drexel University and AARP Pennsylvania indicated that adults over 65 are less likely to use technology for health purposes. Rural areas face a barrier to a lack of broadband internet access. To reduce the digital divide in rural areas, the Connect with Tech Program aims to provide residents of Pennsylvania with tablets and internet access resources as needed so that individuals can access telehealth services and manage their health more effectively. 

Grant Funded

This project is funded by a Center for Disease Control and Prevention (CDC) Covid-19 Health Disparities Grant through the Pennsylvania Department of Health. Connect with Tech from TechOWL at the Institute o Disabilities was the primary deliverable for the funded grant. The Institute on Disabilities combined Connect with Tech with three other deliverables to form the Health Equity Consortium at Temple University.

Purposes of the Health Equity Consortium

To address COVID-19 and health equity in medically underserved populations within different states by implementing strategies, interventions, and services that address systemic barriers and discriminatory practices that put the aforementioned populations at a higher risk for diseases like COVID-19. 

To create collaborations/key partnerships between state-funded departments and social service delivery/community organizations to decrease COVID-19-related health disparities and increase access to resources among populations at higher risk. 

To build technology (solutions) infrastructures for populations at higher risk and underserved, including racial and ethnic minority populations and people living in rural communities, to address disparities in the current pandemic and set a foundation for further responses. The digital divide will be mitigated through (1) device ownership, (2) digital literacy, and (3) connectivity.  

The Information Superhighway

The information superhighway is an integral part of our society. When the pandemic shutdown happened, the physical roads were empty, but the information superhighway was busier than ever. It was how many of us connected with friends and family, got groceries, shopped, and went to the doctor. To drive on the information superhighway, we needed (1) a vehicle – a device like a computer, smartphone, or tablet, (2) a driver’s license – the knowledge to use the device, and (3) an on-ramp – a connection to the internet. People with all these elements were socially included, and those without any of these elements were excluded. Many people with disabilities found themselves isolated and without the necessary elements to navigate the information superhighway. Overnight – technology that was a perceived luxury became vital to health and wellbeing.  

The Vehicle

With this metaphor, devices were the vehicles. We discussed the considerations of getting devices into the hands of people with disabilities and others at risk for health inequity. Will the focus be on used or new equipment? Will the person borrow or own the device? What are the pros and cons of different operating systems? What is the difference between an open or more restricted application process? How to approach funding devices? What are strategies to navigate supply chain issues?  

The Driver’s License

Continuing with the metaphor, the driver’s license is digital literacy. We explored digital literacy and strategies to get novice technology users the skills they need to succeed. How to leverage natural supports? What are accessible resources to help new technology users get started? How do we build a cohort of tech coaches? How can troubleshooting happen without an internet connection? 

The On-Ramp

The on-ramp is internet access.– How will we get internet access for people without connectivity? What is the new federal Affordable Connectivity Program? When to consider personal hot spots? What are the use cases for public Wi-Fi? What about rural communities with poor connectivity? 

Connect with Tech Beginnings

Within days of the pandemic shutdown, TechOWL initiated a used tablet distribution project and, within a year, started Connect with Tech – a multifaceted program to not only (1) give away devices to people [device ownership] but also (2) teach people how to use the devices [digital literacy] and (3) make sure they can get on the internet [connectivity.]

Device Ownership

People across Pennsylvania needed to personally technology devices. We have many managed iPads in our Assistive Technology Lending Library (ATLL.) Borrowers can borrow the iPads for 9 weeks, but they want to own them. Connect with Tech was built upon the Telecommunication Device Distribution Program to determine eligibility and procure and distribute actual technology devices. to members of the target population(s) statewide. We simplified the process to make it more accessible.These devices will be equipped with apps for:  

• reporting, contract tracing, and vaccination planning  
• learning about COVID-19 
• common sense and culturally meaningful messaging about COVID-19  

Digital Literacy

We leveraged our relationships with community organizations to create and deploy digital literacy and COVID-19 health literacy applications and training to the target populations. When we launched the program, we hired and trained a workforce of student workers as “technology coaches” to provide support.

Internet Access

We intended to leverage and expand existing relationships with local community partners to create broadband or hotspot access in all 67 PA counties. We considered:

• Public broadband in community spaces such as parks, libraries, and schoolyards.  
• Individual hotspots and data plans for individual internet access.

However, we launched at the same time as the federal Affordable Connectivity Program launched. It made more sense to facilitate enrollment in this program, so we shifted to helping people get enrolled.

Connect with Tech Implementation

Community Outreach

Marketing the program included social media marketing and creating a unique distribution list. The student workers hired as “tech coaches” spent the first 2-3 months creating a distribution list of organizations across the Commonwealth. Because our known contacts we mostly members of the disability community, we needed to expand our typical outreach into other marginalized communities. We collected contact information for churches, community organizations, and other programs. We contacted these organizations with information about Connect with Tech, including instructions on how to help individuals apply and an informational flyer. 

 Documentation

We developed a project database in REDCap. REDCap was developed at Vanderbilt University to assist researchers with research projects. It is HIIPA compliant and (more importantly) approved by Temple University.

We developed 5 instruments in REDCap.

• Application – The form is available online or in print. Applicants can also call us, and we will complete the instrument.
• Eligibility – The program coordinator is responsible for review of the application to determine eligibility. He works with a graduate assistant to review all of the applications. Sometimes we need to do a follow-up call.
• Distribution – The serial number, ship date, etc., is entered into the database when a tablet kit is shipped.
• Support – A tech coach reaches out to each recipient to inform them that a tablet has shipped. Every instance of contact or support is documented with this instrument.
• Satisfaction – A different student worker contacts the applicant and gathers information regarding the recipient’s experience and satisfaction.

We use this information to analyze the program and generate reports for our funders.

Eligibility

We created a simple application that can be completed within minutes. We do not require proof of eligibility reason (i.e., members of a group that may experience health inequity). We check the address to ensure we have not already sent a tablet kit to that household. We make exceptions if the address is a congregate living or organization for the unhoused.

There are good programmatic reasons to use a simple application. If we require proof, the applicants would have to be able to upload information, and they don’t have the technology to do so. Also, the time it would take to verify the accuracy of the information submitted would substantially slow the program’s capacity. The equipment is not expensive, so we can absorb the loss from fraudulent applications.

Set Up and Shipping

Student workers set up the tablets, package the tablet kits, and deliver the kits to the carrier for shipment. When an application is approved, we create shipping labels with tracking numbers. We send the tracking number to the applicant.

Tech Support

The application asks the recipient to consider who in their lives can provide tech support. This gets the applicant to think about natural supports. Presumably, this cuts down on our support requests.

The tech coaches provide initial and ongoing support to the recipients. When a tech coach is assigned to a recipient, the tech coaches reach out to introduce themselves and provide their contact information to the recipient. Ongoing tech support includes helping recipients set up their tablets, create emails, learn the basic operation of the tablet, etc. 

Satisfaction Surveys

We designate a person to collect data on the recipients’ experience and satisfaction with the program. These surveys are collected after at least three months of delivery.

Tablet Kits 

• Tablet: Samsung Galaxy A7 Lite 
• Apps – A student worker or staff member turns on and connects the tablet to WiFi. The apps for “Easy Tablet Help,” “Coronavirus Information,” and “Navigating TeleHealth” are installed on each tablet.
• Case – A student worker or staff member puts a case on the tablet.
• Stylus – A stylus is included for people with dexterity issues.
• Headset – A headset is provided for use in noisy environments.
• Insert – We include contact information and instructions on how to turn on the tablet.

Resources 

Generations on Line

(https://www.generationsonline.com/ ) 

Generations on Line is an impressive non-profit dedicated to digital literacy for senior citizens. They provide programs and easy detailed instructions for users needing information on digital literacy skills. 

For our program, we collaborated with Generations on Line to add three tablet apps before the tablets were distributed. These apps provide detailed instructions on different digital skills, information on how to use telehealth services, and vaccine information. 

RedCap 

(https://projectredcap.org/software/ )  

CDC Health Disparities Grant

(https://www.cdc.gov/publichealthgateway/partnerships/COVID-19-Health-Disparities-OT21-2103.html)  

Temple University, Insitute on Disabilities COVID-19 Health Disparities

(https://disabilities.temple.edu/programs-services/health-equity/covid-19-health-disparities ) 

Affordable Connectivity Program

(https://www.fcc.gov/acp) 

Observation and Statistics 

Connect with Tech primarily targets Pennsylvanians who do not have access to technology. However, our data also shows that 41 % of our applicants identify as having a disability; this could be explained by the fact that TechOwl is an organization that primarily serves individuals with disabilities. TechOwl’s contacts, therefore, are focused on disability resources and serving this population. While marketing our program, many of the organizations we reached out to were contacts of TechOwl; however, we did also reach out to a variety of state/county organizations (e.g., homeless and women’s shelters, religious gathering places, county departments, food banks, nonprofits, etc.) 

As of January 26, 2023, Connect with Tech has distributed 3,952 tablets to residents in ALL of Pennsylvania’s 67 counties.  

The top three Pennsylvania counties of distribution to persons with disabilities are Philadelphia, Delaware, and Erie which are metropolitan counties.  

Future goals/Directions:  

We are looking for additional funding to carry this much needed program into the future. Additionally, we hope that other states can replicate Connect with Tech. We also have learned that there is benefit when a disability organization such as TechOWL collaborates with other marginalized communities.