Publication date: 9 September 2021
DIGIFALE is a unique approach with the Pacific community that builds people’s digital literacy and then supports them to use this knowledge to access health and other online services.
The initiative has received funding from the Ministry of Health’s Digital Enablement Programme, which provides support for innovation in digital health care. The programme has a particular focus on co-investing in projects that improve access or participation for people who do not access health services and need to. It’s all about improving equity.
The Ministry is working closely with project teams, sharing learning between participating organisations as a community of practice and looking for opportunities to help others learn from these initiatives as they adopt and promote these or similar services elsewhere. The projects are examples of the types of innovation that will be supported by the better access to information enabled by the Hira programme.
Hira will be an ‘ecosystem’ of data and digital services that will enable consumers to access and control their health information through their choice of website or application using a digital device such as a smartphone, tablet or computer. New Zealanders will be more empowered to manage their health, wellbeing and independence. Organisations can work together to share information so that people don’t have to repeat personal details multiple times. Clinicians can harness digital technologies to improve services. The sector and digital innovators can design and contribute innovative data and digital services, making Hira more powerful.
DIGIFALE is provided by Moana Research, an organisation with a focus on supporting families to have access to essential services and resources. Innovations Lead Amio Matenga Ikihele says the initiative harnesses the intergenerational digital skills of Pacific young people to teach their elders digital literacy, in a church setting.
‘We want to reduce digital inclusion in Pacific communities. Research shows these are the same communities that experience health disparities. If we are to encourage the use of digital platforms to access health services, we need to make sure from the very beginning that people have digital technology skills. And then build up their confidence to the point where they can self-manage their conditions online, or make doctors’ appointments. It’s a process that takes time, but when done right from the beginning, there are huge benefits for families.’
DIGIFALE is a series of church-based workshops. Participants are provided with smartphones, and two months’ worth of free data.
‘Initially, the focus is on building basic mobile literacy,’ says Amio, ‘like getting to know how a mobile phone works. Then people learn simple functions like taking photos, text messaging or scanning QR codes, and finally more advanced skills like using your patient portal to make appointments and get test results online, and searching for credible health websites.
‘You have to go along that journey with people you trust, within a safe environment, in a group setting. In the pilot, people were able to talk about their experiences and what they had learnt the week before. Eventually it got to the point where everyone within the group was texting each other, within that pilot. So by the end of our weeks together we created a group text.’
The pilot of DIGIFALE was carried out with a Niue community in South Auckland. The Ministry of Health digital enablement funding will allow the initiative to be also be expanded to Cook Island, Samoan and Tonga groups, as well as another Niue group.
‘This recognises Pacific peoples aren’t one homogenous group. We have to think about how we can reach our ethnic-specific groups, and that includes facilitation and resources in their first language. If we can build people’s confidence using technology in their first language, within church settings – a space where they feel safe – the transition to using digital tools will be much easier than if they were to go to a completely new setting, have unfamiliar facilitators and everything is in English.’
Young people are trained within Pacific churches to become DIGIFALE navigators, for their older people.
‘We don’t want to become viewed as the experts ourselves,’ says Amio. ‘It is young people who belong to that church who will be the ongoing teachers and experts. We are trying to reach as many Pacific churches as we can. Churches already have the structures in place to have those ongoing relationships.’
She says the initiative has the unintended benefit of the young people who are the teachers, also becoming more connected to online services.
‘Young people are digitally savvy but they don’t necessarily visit primary health care services when they need to. They might work with an older person to download their patient portal, and that is the catalyst for them to also download their own patient portal and get a fix on their health information.’
While the digital divide has been an issue for Pacific communities for some time, the idea for DIGIFALE was kick-started during the 2020 COVID-19 lockdown.
‘During COVID, Moana Research undertook a rapid review of telehealth services for a district health board. We found that family members within a household were helping elderly people or older adults go on-line. But if you don’t have the skills or the right hardware and connectivity to get online, you can’t take advantage of the services. DIGIFALE is about providing all three.’
Amio emphasises that having access to online health care is about giving people a choice.
‘Some people want to see their doctor in person. But if an online option is available as well, this adds to their choices. And some people will use a mixture of face-to-face and online services – such as texting to connect with their health provider and then visiting.’
She says challenges for the initiative include helping people to understand the value of digital technology.
‘Changing behaviour takes time and when it becomes too difficult people can revert back to what they have done beforehand. So it is doing things in small steps.’
During the COVID-19 lockdown, a lot of church services were streamed online.
‘That provides an incentive for an older person to get online – here’s YouTube, this is where you will find an archive of sermons from your minister and this is how you can search it. Having that as an entry point then allows us to introduce people to other functionality and services, including health services.’