Community Stakeholder-Driven Technology Solutions Towards Rural Health Equity: A Concept Mapping Study

Abstract Background Promoting inclusive health and social care for rural populations requires new community-focused innovations, technological infrastructure, creative design thinking, and multi-stakeholder collaboration. Technology holds great potential for promoting health equity for rural populations, who have more chronic illnesses than their urban counterparts but less access to services. Yet, more participatory research approaches are needed to gather community-driven health technology solutions. The purpose of this research was to collaboratively identify and prioritize action strategies for using technology to promote rural health equity through community stakeholder engagement. Methods Concept mapping, a quantitative statistical technique, embedded within a qualitative approach, was used to surface and synthesize technological solutions towards rural health equity from community stakeholders in three steps: 1. idea generation; 2. sorting and rating feasibility/importance; and 3. group interpretation. Purposeful recruitment strategies were used to recruit key stakeholders and organizational representatives from targeted rural communities. Results Overall, 34 rural community stakeholders participated in the concept mapping process. In Step 1, 84 ideas were generated that were reduced to a pool of 30. Multi-dimensional scaling and cluster analysis resulted in a 6-cluster map representing how technological solutions can contribute toward rural health equity. The clusters of ideas included technological solutions and applications, but also ideas to make healthcare more accessible regardless of location, training and support in the use of technology, ensuring digital tools are simplified for ease of use, technologies to support collaboration among healthcare professionals, and ideas for overcoming challenges to data sharing across health systems/networks. Each cluster included ideas and priority areas that were rated as equally important and feasible. Key themes included organizational and individual level solutions, and the development of new technologies while connecting patients to these technologies. Conclusions The concept mapping exercise enabled rural community stakeholders to co-identify technological solutions toward rural health equity. Overall, the grouping of solutions revealed that technological applications require not only access, but also support and collaboration. Concept mapping is a tool that can engage rural community stakeholders in the identification of technological solutions for promoting rural health equity.