Digital Disparities Among Home Care Aides in Washington State

Introduction: This study aims to examine factors contributing to digital disparities among Medicaid Home Care Aides (HCAs) who provide long-term care in Washington State. Despite the profound impact of digital transformation on the HCAs, little research has been conducted. Objectives: We conducted a cross-sectional survey to examine digital disparities among the HCAs, focusing on 3 primary domains: access , use , and efficacy. Methods: Randomly selected HCAs received surveys via online, phone, and mail. A survey weight was applied to account for oversampling the language groups. Multivariate regressions were conducted. Results: Education and English proficiency are critical factors contributing to all 3 domains of digital disparities. Age and gender are associated with use and efficacy . Income predicts access and efficacy . Conclusion: In conclusion, (1) socioeconomic factors play a significant role in digital disparities; (2) English proficiency level is a critical determinant of digital disparities; (3) Efficacy matters in addressing digital disparities. We discussed that HCAs’ device access remains lower than the average U.S. household. Digital inequity, rooted in socioeconomic factors and language barriers, could hinder their ability to participate in workforce development opportunities such as online training, certification programs, and communication platforms. Therefore, promoting digital equity through access to affordable devices, digital navigators, multilingual websites, and culturally and linguistically appropriate content can empower HCAs to engage in continuous learning, access essential resources, and deliver more responsive and effective care. These efforts ultimately strengthen the HCA workforce and enhance the quality of care clients receive.