Background Texas is home to nearly 7 million people without broadband access, representing a large population unable to utilize telehealth services. Extending internet access thereby promotes health equity. Link Health is a Boston-based digital health program addressing this issue through a satellite program in Houston. Link Health helps disseminate information about federal programs such as the ACP and Lifeline, which connect eligible participants to low-cost broadband internet.

Methods Link Health enrolls participants in-person and digitally. Ambassadors facilitate in-person enrollments through health centers and community events, discussing eligibility and applications for ACP and Lifeline. A Google Form collects participant’s demographic data. Participants are transferred to the FCC National Verifier site to complete enrollment. Digital sign-ups are completed via Link Health’s webpage or by responding to SMS messages with program information from remote ambassadors. Here, we compare enrollment across Houston and Boston to understand the populations served.

Results Data collected in or after July 2023 were included. During this time, 800 participants were enrolled (402 in Boston; 398 in Houston). A greater proportion of participants enrolled in person in Boston (56%) than in Houston (47.2%). Proportionally more enrollees in Houston preferred to speak English (70.4%) than Spanish (28.9%) than in Boston, where the language split was more equal: 49.5% preferred English and 40.9% Spanish. A breakdown of language by sign-up method revealed a higher proportion of Spanish speakers enroll in-person rather than digitally: 78.3% of Spanish speakers in Houston and 74.4% in Boston versus 34% of English speakers in Houston and 50.2% in Boston. Racial composition of enrollees was similar across cities but not sign-up method: in Boston, 23.3% of enrollees were Black, 52.2% were Hispanic, and 14.4% were White. In Houston, 28.6% of enrollees were Black, 49.7% were Hispanic, and 13.8% were White. Across both cities in-person enrollees were 37% Black or African American, 68% Hispanic and 33% White.

Conclusion The Link Health Digital Equity Program has major implications in closing the digital divide beyond Boston. The disconnected population in Texas can benefit from the continuation of federal programs like the ACP and Lifeline which facilitate access to telehealth services. Maintaining in-person resources is essential to equitably serve these populations, many of whom speak Spanish and are Hispanic.