Perceptions, attitudes, and experience regarding mHealth among homeless in New York City shelters

Mobile health may be an effective means of providing access and education to the millions of homeless Americans. We conducted semi-structured interviews with 50 homeless from different shelters in New York City (NYC) to evaluate their perceptions, attitudes and experiences regarding mobile health. Participants’ average age was 51.66 (SD±11.34) years; duration of homelessness was 2.0 (SD±3.10) years.  The majority had a mobile phone with the ability to receive and send text messages. Most participants attempted to maintain the same phone number over time. The homeless were welcoming and supportive of text messaging regarding healthcare issues including appointment reminders, health education, or management of diseases considering their barriers and mobility, and believed it would help them access necessary healthcare. Overwhelmingly they preferred text reminders that were short, positively framed, and directive in nature compared to lengthy or motivational texts. The majority believed that free cell phone plans would improve their engagement with, help them navigate, and ultimately improve their access to care. These positive attitudes and experience could be effectively used to improve the homeless healthcare. Policies to improve access to mobile health and adapted text messaging strategies regarding healthcare needs of this mobile population should be considered.