What is it about?
Many people have trouble paying for food, keeping stable housing, or getting to appointments, and these problems affect health as much as any illness. Clinics and community programs increasingly use apps and websites to screen for these needs and connect people to help. Most of these tools were built without asking the people expected to use them. We asked. Working through FIU’s NeighborhoodHELP program in Miami, we interviewed 26 adults with low incomes about how they use phones and apps and what they would want from a tool that helps with food, housing, transportation, and similar needs. We also held six focus groups with 28 physicians, social workers, and outreach staff who work with these households every day. We then reviewed 17 existing apps and websites to see how well they match what we heard. Participants described five things a useful tool must do: work in their language, with pictures and plain words; handle several needs at once and let them save a half-finished questionnaire; speak to them with encouragement and offer a path to a real person; explain what to do next and show what other users thought of a service; and make clear how their information is protected, with the option to skip questions they would rather not answer. Few of the 17 tools did these things. Most were in English only, covered one need at a time, lost progress if a user stopped partway, and said little about privacy.
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Photo by Georg Pflueger on Unsplash
Why is it important?
Screening for food, housing, and transportation needs is now routine in many clinics, and much of it happens on a screen. A tool that is hard to use in a second language, that drops a questionnaire when the bus arrives, or that asks for sensitive information without saying why will be abandoned by the people it was meant to reach. The screening then records nothing, and the need goes unmet. This study gives developers and health systems a checklist drawn from users themselves and from the staff who serve them, and it shows where current tools fall short. The findings are shaping FIU Thrive, an app our team is designing to assess the needs of a whole household and connect it to services in English, Spanish, and Haitian Creole. The larger lesson applies beyond any one app: tools for people with low incomes should be designed with them, not only for them.
Perspectives
After more than three decades as a family physician, I’ve seen firsthand how challenges like food insecurity, unstable housing, and lack of transportation profoundly affect my patients’ health, often more than any medication I could prescribe. Through our NeighborhoodHELP program, I’ve worked alongside families facing these obstacles for over 15 years, and I’ve witnessed the frustration when well-intentioned resources remain out of reach simply because systems are too fragmented or complicated. What makes this research particularly meaningful to me is that we didn’t just study the problem from a distance. We sat down with the people living these experiences and the frontline workers supporting them. Their insights were eye-opening, even for someone who thought he understood the challenges well. Hearing directly from participants that motivational messages matter, that questionnaires need to respect their time, and that trust must be earned through transparency fundamentally shaped how we are designing the FIU Thrive platform. This work reminds me why I went into medicine: to serve and learn from the community. I hope it inspires other researchers and developers to partner with the people they aim to help.
David Brown
Florida International University
Read the Original
This page is a summary of: Evaluating the Needs and Characteristics of Individuals of Low Socioeconomic Status Using Digital Health Technology to Address Health-Related Social Needs: Mixed Methods Study With Patients and Care Providers, JMIR Human Factors, September 2025, JMIR Publications Inc.,
DOI: 10.2196/69545.
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