{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:51:10Z","timestamp":1785855070834,"version":"3.56.0"},"reference-count":85,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic disrupted traditional health care delivery models, exacerbating disparities between those with and without ready access to digital technology. This digital divide poses a structural barrier to accessing equitable healthy aging resources and dementia care. Latino and Hispanic individuals, who constitute nearly half of Los Angeles County\u2019s population and face a projected tripling of Alzheimer disease and related dementia (ADRD) prevalence by 2040, are particularly impacted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This paper aims to examine the barriers and facilitators affecting access to digital health education and resources for Alzheimer disease (AD) prevention and care management during the COVID-19 pandemic. This study focuses on the digital barriers possibly hindering Spanish-speaking Latino and Hispanic individuals in Los Angeles County from using online services offering critical AD prevention and care resources amid the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a conceptual model based on users\u2019 digital access or web literacy and language as barriers and facilitators impacting access to digital AD prevention and care resources. Between January 2022 and February 2022, we identified 15 websites of local organizations providing digital AD prevention services and resources in Los Angeles County during the pandemic. We applied our digital divide model to qualitatively evaluate the 15 websites. A post hoc analysis was conducted to reevaluate the 15 websites in 2025, and interrater reliability was evaluated using a Cohen \u03ba analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of the 15 websites, 5 featured web navigation accessibility tools (4\/15 in 2025), 4 provided content available in Spanish (6\/15 in 2025), and 2 included resources for family dialogue about AD care and management (3\/15 in 2025). One website showed cultural and linguistic responsiveness in its content (2\/15 in 2025). Cohen \u03ba analysis revealed substantial agreement for digital acceptability factors including Spanish language (\u03ba=0.71), resources available in Spanish (\u03ba=0.71), and family dialogue resources (\u03ba=0.74). Agreement for web accessibility tools was moderate at (\u03ba=0.53). We uncovered other unforeseen structural barriers to digital access, including email subscription requirements, English language\u2013centered online forms, and the limited availability of Spanish-speaking staff.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study highlights structural barriers hindering access to digital AD prevention and care resources tailored to the needs and values of Latino and Hispanic communities living in Los Angeles County. The findings emphasize the need to bridge the digital gap by incorporating user-friendly features and culturally and linguistically responsive elements in website design and implementation. This approach will move our field toward equitable access to digital ADRD prevention and care resources by mitigating structural barriers that sustain ADRD disparities in Latino and Hispanic communities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/67147","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T04:25:10Z","timestamp":1747628710000},"page":"e67147","source":"Crossref","is-referenced-by-count":2,"title":["Addressing Digital Disparities in Alzheimer Disease by Improving Access to Alzheimer Resources for Spanish-Speaking Latino or Latina Individuals in Los Angeles County: Mixed Methods Study"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3744-5033","authenticated-orcid":false,"given":"Stephanie","family":"Ovalle-Eliseo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6580-0139","authenticated-orcid":false,"given":"Aisha","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3942-1824","authenticated-orcid":false,"given":"Gabriela","family":"Islas Huerta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6351-6720","authenticated-orcid":false,"given":"Keith","family":"Vossel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7128-3209","authenticated-orcid":false,"given":"Lorena H","family":"Monserratt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5513-815X","authenticated-orcid":false,"given":"Mirella","family":"D\u00edaz-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Alzheimer's disease facts and figuresAlzheimer's Association2025-07-21https:\/\/www.alz.org\/alzheimers-dementia\/facts-figures","DOI":"10.1002\/alz.70235"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-023-01858-9"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-023-11602-8"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-023-02505-2"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.2196\/25706"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/gps.1037"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1177\/1090198104263660"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-012-9666-7"},{"key":"ref9","author":"Stroud, C","year":"2021","journal-title":"Meeting the Challenge of Caring for Persons Living with Dementia and Their Care Partners and Caregivers: A Way Forward"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17078"},{"key":"ref11","unstructured":"Health IT legislationAssistant Secretary for Technology Policy2022-10-27https:\/\/www.healthit.gov\/topic\/laws-regulation-and-policy\/health-it-legislation"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocz115"},{"key":"ref13","unstructured":"CherewkaAThe digital divide hits U.S. immigrant households disproportionately during the COVID-19 pandemicMigration Policy Institute202009032022-04-18https:\/\/www.migrationpolicy.org\/article\/digital-divide-hits-us-immigrant-households-during-covid-19"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3390\/su152215916"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1080\/17538157.2018.1433674"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-160650"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.2196\/14254"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.2196\/33364"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1197\/jamia.M1535"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.techfore.2021.121359"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2021.306386"},{"key":"ref22","unstructured":"Guiding an improved dementia experience (GUIDE) modelCenters for Medicare & Medicaid Services2024-04-23https:\/\/www.cms.gov\/priorities\/innovation\/innovation-models\/guide"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-200461"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1515\/1944-2866.1178"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1080\/01634370903361847"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1177\/23337214221081372"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.2196\/45045"},{"key":"ref28","unstructured":"Digital literacyAmerican Library Association Literacy Clearinghouse2022-04-28https:\/\/literacy.ala.org\/digital-literacy\/"},{"key":"ref29","unstructured":"BrownAL\u00f3pezGLopezMHDigital divide narrows for Latinos as more Spanish speakers and immigrants go onlinePew Research Center201607202022-05-11https:\/\/www.pewresearch.org\/hispanic\/2016\/07\/20\/digital-divide-narrows-for-latinos-as-more-spanish-speakers-and-immigrants-go-online\/"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5065"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.2196\/11931"},{"key":"ref32","unstructured":"McClainCVogelsEAPerrinASechopoulosSRainieLNavigating technological challengesPew Research Center202109012022-04-18https:\/\/www.pewresearch.org\/internet\/2021\/09\/01\/navigating-technological-challenges\/"},{"key":"ref33","unstructured":"MartinezLEBustamanteABalderas-Medina AnayaYDom\u00ednguez-VillegasRSantizo-GreendwoodSDiazSHayes-BautistaDCOVID-19 in vulnerable communities: an examination by race\/ethnicity in Los Angeles and New York CityUCLA Latino Policy & Politics Initiative20202022-05-02https:\/\/escholarship.org\/uc\/item\/65w902pn"},{"key":"ref34","doi-asserted-by":"crossref","DOI":"10.4159\/9780674028845","author":"Bronfenbrenner, U","year":"1979","journal-title":"The Ecology of Human Development: Experiments by Nature and Design"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1177\/07399863211041214"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gby123"},{"key":"ref37","unstructured":"The Spanish language in Los AngelesLos Angeles Almanac2024-04-16https:\/\/www.laalmanac.com\/population\/po48s.php"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.18865\/ed.25.3.245"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.2128"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13027"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000004793"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000004412"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1080\/15524256.2010.529009"},{"key":"ref44","author":"Kleinman, A","year":"1988","journal-title":"The Illness Narratives: Suffering, Healing, and the Human Condition"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-023-01550-w"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.2196\/10389"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2021.0182"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1177\/0733464818770772"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gny138"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1177\/0896920513516025"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1002\/jee.20377"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1111\/spc3.12735"},{"key":"ref53","unstructured":"GENESIS - Geriatric Services Intervention Support ProgramsLos Angeles County Department of Mental Health2022-02-07https:\/\/dmh.lacounty.gov\/our-services\/older-adults\/genesis\/"},{"key":"ref54","unstructured":"Hispanics\/Latinos in Los Angeles county by the numbersLos Angeles Almanac2022-04-28https:\/\/www.laalmanac.com\/population\/po722.php"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.109150"},{"key":"ref56","unstructured":"UserWay2023-06-16https:\/\/userway.org\/"},{"key":"ref57","unstructured":"EqualWeb2023-06-16https:\/\/www.equalweb.com"},{"key":"ref58","unstructured":"Alzheimer's Los Angeles2022-01-27https:\/\/www.alzheimersla.org\/"},{"key":"ref59","unstructured":"City of Los Angeles Department of Aging2022-02-07https:\/\/aging.lacity.gov\/"},{"key":"ref60","unstructured":"California Southland ChapterAlzheimer's Association2022-01-28https:\/\/www.alz.org\/socal"},{"key":"ref61","unstructured":"Jewish Family Service LA2022-02-03https:\/\/www.jfsla.org\/"},{"key":"ref62","unstructured":"Health and aging servicesCounty of Los Angeles Public Health2022-02-07http:\/\/publichealth.lacounty.gov\/aging\/has\/"},{"key":"ref63","unstructured":"Leeza's Care Connection2022-02-04https:\/\/leezascareconnection.org\/home"},{"key":"ref64","unstructured":"LA CRC - resources for family caregivers in Los Angeles CountyLos Angeles Caregiver Resource Center2022-02-04https:\/\/losangelescrc.usc.edu\/"},{"key":"ref65","unstructured":"UCLA, Alzheimer's, dementia, memory clinic, doctors, physiciansThe Mary S. Easton Center for Alzheimer\u2019s Research and Care at UCLA2022-01-27https:\/\/eastonad.ucla.edu\/"},{"key":"ref66","unstructured":"ONEgeneration2022-01-27https:\/\/www.onegeneration.org\/about-us\/"},{"key":"ref67","unstructured":"OPICA2022-02-03https:\/\/www.opica.org\/"},{"key":"ref68","unstructured":"Rancho Los Amigos2022-01-28https:\/\/ranchomemoryclinic.org\/"},{"key":"ref69","unstructured":"St. Barnabas Senior Services2022-02-04https:\/\/www.sbssla.org"},{"key":"ref70","unstructured":"Communities Actively Living Independent & Free2022-02-03https:\/\/calif-ilc.org\/adrc\/"},{"key":"ref71","unstructured":"Wise and Healthy Aging2022-01-31https:\/\/www.wiseandhealthyaging.org"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.3390\/educsci13030237"},{"key":"ref73","unstructured":"Why isn\u2019t Google translate enough for your global business?LinkedIn202203302022-04-18https:\/\/www.linkedin.com\/pulse\/why-isnt-google-translate-enough-your-global-business-mcfelder-com\/"},{"key":"ref74","unstructured":"KrupaARoarkJBBarrettKBThe critical role of web accessibility in health information access, understanding, and useAmerican Health Information Management Association Foundation20222024-03-14https:\/\/ahimafoundation.org\/research\/thecriticalrole-of-web-accessibility-in-health-information-access-understanding-and-use\/"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1007\/s10209-020-00788-7"},{"key":"ref76","unstructured":"Americans with Disabilities Act of 1990, as amendedU.S Department of Justice Civil Rights Division2024-04-30https:\/\/www.ada.gov\/law-and-regs\/ada\/"},{"key":"ref77","unstructured":"Making your website senior friendly: tips from the National Institute on Aging and the National Library of MedicineNational Institute on Aging20212024-01-03https:\/\/www.datachieve.com\/wp-content\/uploads\/2021\/07\/Making-Your-Website-Senior-Friendly-Tip-Sheet.pdf"},{"key":"ref78","doi-asserted-by":"publisher","DOI":"10.1016\/j.zefq.2022.11.010"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.1027\/2151-2604\/a000470"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-05125-y"},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.1080\/14790718.2023.2236150"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1177\/1609406917748992"},{"key":"ref83","unstructured":"Equity for Latinx-Hispanic Healthy Aging Lab2025-05-13https:\/\/elhalab.org\/"},{"key":"ref84","unstructured":"ELHA UCLAInstagram2025-05-13https:\/\/www.instagram.com\/elhaucla\/"},{"key":"ref85","unstructured":"The equity for Latinx-Hispanic healthy aging lab at UCLAFacebook2025-05-13https:\/\/www.facebook.com\/p\/The-Equity-for-Latinx-Hispanic-Healthy-Aging-Lab-at-UCLA-100083709112504\/"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2025\/1\/e67147","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T14:00:02Z","timestamp":1785852002000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2025\/1\/e67147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":85,"URL":"https:\/\/doi.org\/10.2196\/67147","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.67147","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,13]]}}}