Mobile Health and Cultural Competencies as a Foundation for Telehealth Care: Scoping Review

2021 
All health care settings are challenged to provide timely and evidence-based care, particularly for culturally diverse patients with behavioral health disorders. Telepsychiatry and telebehavioral health improve access to care, yet mobile health technologies may have even more promise. A scoping review examined the research question: “What are the components of culturally competent, mobile health care, and what approaches have clinicians and systems taken to implement this care, train clinicians and evaluate outcomes?” The literature search from January 2000 to March 2020 focused on keywords in four concept areas: (1) competencies; (2) mobile health; (3) culture; and (4) clinical care. Of 2471 papers, 183 papers were directly relevant to the concepts. Few studies and professional organizations’ publications specifically discuss skills or competencies for mobile health and cultural factors. Existing telehealth competency sets (i.e., video, social media, mobile health, telebehavioral health, asynchronous) have limited cultural components, and one outline of culturally competencies exists without mention of technology. The landscape of culturally competence is expanded with cultural humility and safety constructs. New sets of mobile health and cultural competencies were constructed—with integration where possible—and training and administrative approaches are suggested. Effectiveness research is needed to implement and evaluate mobile health and cultural competencies. Research is also needed to understand how these competencies align with telehealth, rural health, and unique populations (e.g., refugees, Indigenous peoples, migrant workers, gender diverse groups). Outreach and advocacy for the inclusion of people with lived and living experience is essential to this research.
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