Research Output

Mobile technology utilization among patients from diverse cultural and linguistic backgrounds attending cardiac rehabilitation.

  Background: Barriers to attending cardiac rehabilitation (CR), including cultural and linguistic differences, may be addressed
by recent technological developments. However, the feasibility of using these approaches in culturally and linguistically diverse
patients is yet to be determined.
Objective: This study aims to assess the use of mobile technologies and features, as well as confidence in utilization across
patients speaking different languages at home (ie, English, Mandarin Chinese, and a language other than English and Mandarin
[other]) and are both eligible and physically suitable for CR. In addition, the study aims to determine the sociodemographic
correlates of the mobile technology/feature use, including language spoken at home in the three groups mentioned above.
Methods: This is a descriptive, case matched, comparative study. Age and gender-matched patients speaking English, Mandarin
and other languages (n=30/group) eligible for CR were surveyed for their mobile technology and mobile feature use.
Results: ‘Participants had a mean age of 66.7 years (SD 13, n=90, range 46-95), with 53.3% (48/90) male. The majority (82/90,
91.1%) used at least one technology device, with 87.8% (79/90) using mobile devices, the most common being smartphones
(57/90, 63.3%), tablets (28/90, 31.1%), and text/voice-only phones (24/90, 26.7%). More English-speaking participants used
computers than Mandarin or “other” language speaking participants (P=.003 and .02) and were more confident in doing so
compared to Mandarin-speaking participants (P=.003). More Mandarin-speaking participants used smartphones compared with
“other” language speaking participants (P=.03). Most commonly used mobile features were voice calls (77/82, 93.9%), text
message (54/82, 65.9%), the internet (39/82, 47.6%), email (36/82, 43.9%), and videoconferencing (Skype or FaceTime [WeChat
or QQ] 35/82, 42.7%). Less Mandarin-speaking participants used emails (P=.001) and social media (P=.007) than English-speaking
participants. Speaking Mandarin was independently associated with using smartphone, emails, and accessing the web-based
medication information (OR 7.238, 95% CI 1.262-41.522; P=.03, OR 0.089, 95% CI 0.016-0.490; P=.006 and OR 0.191, 95%
CI 0.037-0.984; P=.05).
Conclusions: This study reveals a high usage of mobile technology among CR patients and provides further insights into
differences in the technology use across CALD patients in Australia. The findings of this study may inform the design and
implementation of future technology-based CR.

  • Type:


  • Date:

    26 June 2018

  • Publication Status:


  • DOI:


  • ISSN:


  • Library of Congress:

    WG 18.2 Cardiology

  • Dewey Decimal Classification:

    616.2 Respiratory diseases

  • Funders:

    Edinburgh Napier Funded


Zhang, L., Ding, D., Neubeck, L., Gallagher, P., Paull, G., Gao, Y., & Gallagher, R. (2018). Mobile technology utilization among patients from diverse cultural and linguistic backgrounds attending cardiac rehabilitation. JMIR Cardio, 2(1), e13.



Mobile Technology, Cultural, Diverse, Linguistic,

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    ©Ling Zhang, Ding Ding, Lis Neubeck, Patrick Gallagher, Glenn Paull, Yan Gao, Robyn Gallagher. Originally published in JMIR Cardio (, 26.06.2018.

    This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Cardio, is properly cited.

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