How to plan for low-tech participants without compromising the study
Digital trials carry a quiet exclusion risk. When a study assumes participants have a recent smartphone, a reliable internet connection, and the confidence to navigate a new app, it is already designed for a subset of people. Not everyone fits that profile. And in many research populations, the people who do not are exactly the ones whose data matters most.
It's worth being honest about where that assumption often comes from. A commentary on ageism in digital health made the case bluntly: many healthcare professionals still hold the outdated belief that older adults and digital tools are simply incompatible, despite older adults adopting digital services rapidly once given a real reason and a workable way to do it during the pandemic. The result of that belief isn't neutral. Older participants get disproportionately excluded from studies that rely on digital platforms, not because they can't engage, but because nobody built a path for them to. Planning for low-tech participants isn't about lowering standards. It's about noticing which of your assumptions were actually just habits.
01. Build multiple ways in
An app should not be the only way to participate. Think about what happens when someone has a phone too old to run the current OS, doesn't want to download anything, has no reliable broadband at home, or simply prefers interacting by text or phone call. Parallel pathways help: SMS surveys, phone-based check-ins, web forms that work without logging in, printed materials sent by post. Not every participant needs all of these, but offering them means the study stays accessible when the default route fails.
02. Write instructions for people who have never done this before
Clear guidance matters more than polished copy. Abstract directions like "navigate to your task list" assume knowledge that many participants do not have. What works better is concrete and literal: screenshots showing the exact screen they will see, step-by-step instructions that name every button ("tap the blue circle labelled Next"), short videos demonstrating the most common tasks, and a phone number to call if anything is unclear. If it takes a coordinator more than two minutes to walk someone through the first login, the onboarding needs reworking, not the participant.
03. Design the interface for older and less confident users
Small design decisions make a significant difference: larger buttons and text that are easier to tap and read, a "save and continue later" option so nothing is lost if they need to stop, a preview before final submission, and error messages that explain what went wrong and how to fix it rather than blocking progress with an unexplained red warning.
04. Prepare the support team properly
The people answering participant questions need to be trained for this specifically. That means avoiding jargon that assumes familiarity ("just scroll down" assumes someone already knows what scrolling looks like on their device), genuine patience with questions that feel basic, scripted walkthroughs for the most common problems, and a clear escalation path for when a phone call alone can't resolve it.
05. Respect is the foundation
Participants who struggle with digital tools often know they are struggling. The way the study responds to that shapes their willingness to continue. Instructions that feel patronising, support staff who sound impatient, or interfaces that make someone feel foolish for not knowing where to tap: all of these cost retention, and they cost it fastest among exactly the participants a study can least afford to lose.
Low-tech does not mean low-value. The participant calling for the third time because they cannot find the form is often one of the most committed people in the study. Design, and support, should reflect that, and so should the assumptions built into the study before either of them was ever written.