"We want that personal touch”: Dilemma of digitalization of healthcare based on community health worker experiences of depersonalization in healthcare.

261 Background: Advancements in digital technology is increasingly shaping healthcare delivery with a potential to address disparities by improving access to, enhancing communication with, and streamlining of healthcare management. Increased digitalization could also contribute to depersonalization from healthcare systems, particularly in individuals with low digital health literacy. We examined Community Health Advisors (CHAs) perceptions on community level experiences with technology in cancer care. Methods: University of Alabama at Birmingham and the University of South Alabama CHAs participated in semi-structured interviews exploring their experiences and perspectives on health and technology literacy challenges. Interviews were audio-recorded, transcribed, and inductively analyzed using NVivo and a constant comparative method leading to key representative themes and exemplary quotes. Results: Thirty-two CHAs, predominantly women (94%) and Black or African American (94%), participated in interviews. CHAs underscored multifaceted interactions of technology and healthcare. CHAs discussed the theme of navigating digital health interfaces alongside patient-provider relationships could result in depersonalization. They illuminated on barriers to and mitigation of depersonalization in healthcare engagement in the community. CHAs also discussed the theme of addressing health literacy as an underlying facet of mitigating depersonalization and low digital health literacy. They situated the feelings of depersonalization in relation to patient views on discomfort with digital services, medical mistrust, and provider cultural illiteracy impacting comprehension and engagement with health information and services. CHAs recommended acknowledging the community level discomforts with technology and healthcare, prioritizing human interaction alongside technology, and tailoring of healthcare services to diverse community needs, and linking to existing community infrastructure. Conclusions: Guided efforts focused on existing community infrastructure and integration of humanistic elements could aid in reducing depersonalization and improving digital health literacy.