A cardiovascular clinic patients’ survey to assess challenges and opportunities of digital health adoption during the COVID-19 pandemic

Dagher, Lilas; Nedunchezhian, Saihariharan; Hajjar, Abdel Hadi El; Zhang, Yichi; Deffer, Orlando; Russell, Ashley; Pottle, Christopher; Marrouche, Nassir F.

doi:10.1016/j.cvdhj.2021.10.007

Cited by 11 publications

(6 citation statements)

References 25 publications

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“…[ 10 – 13 ] Specifically, studies have found that older age and lower education levels are often associated with lower digital health literacy and lower virtual care adoption. [ 26 , 27 ] However, when looking at the proportion of virtual versus in-person visits out of all ambulatory visits in our study (see S4 Appendix figures), we found that non-immigrants had a higher proportion of in-person visits (and therefore lower proportion of virtual visits) compared to immigrants. These results may suggest that non-immigrants were more likely to be offered and/or to choose in-person rather than virtual care.…”

Section: Discussioncontrasting

confidence: 52%

Virtual care use among older immigrant adults in Ontario, Canada during the COVID-19 pandemic: A repeated cross-sectional analysis

et al. 2023

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The critical role of virtual care during the COVID-19 pandemic has raised concerns about the widening disparities to access by vulnerable populations including older immigrants. This paper aims to describe virtual care use in older immigrant populations residing in Ontario, Canada. In this population-based, repeated cross-sectional study, we used linked administrative data to describe virtual care and healthcare utilization among immigrants aged 65 years and older before and during the COVID-19 pandemic. Visits were identified weekly from January 2018 to March 2021 among various older adult immigrant populations. Among older immigrants, over 75% were high users of virtual care (had two or more virtual visits) during the pandemic. Rates of virtual care use was low (weekly average <2 visits per 1000) prior to the pandemic, but increased for both older adult immigrant and non-immigrant populations. At the start of the pandemic, virtual care use was lower among immigrants compared to non-immigrants (weekly average of 77 vs 86 visits per 1000). As the pandemic progressed, the rates between these groups became similar (80 vs 79 visits per 1000). Virtual care use was consistently lower among immigrants in the family class (75 visits per 1000) compared to the economic (82 visits per 1000) or refugee (89 visits per 1000) classes, and was lower among those who only spoke French (69 visits per 1000) or neither French nor English (73 visits per 1000) compared to those who were fluent in English (81 visits per 1000). This study found that use of virtual care was comparable between older immigrants and non-immigrants overall, though there may have been barriers to access for older immigrants early on in the pandemic. However, within older immigrant populations, immigration category and language ability were consistent differentiators in the rates of virtual care use throughout the pandemic.

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Section: Discussioncontrasting

confidence: 52%

Virtual care use among older immigrant adults in Ontario, Canada during the COVID-19 pandemic: A repeated cross-sectional analysis

et al. 2023

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“…Eysenbach ( 2005 ) expressed concern regarding the presentation of efficacy results, emphasizing the need for a more nuanced discuss regarding what worked and did not work in mHealth interventions Eysenbach ( 2005 ). Dagher et al ( 2022 ) suggested bolstering efficacy results by striving recruit and retain those historically left behind in mHealth research including women with lower incomes Dagher et al ( 2022 ). We found pregnant women with higher baseline negative affect were less likely to comply with monitoring technology protocols in a personalized intervention to reduce prenatal distress.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Passive ECG Bio-sensing and EMA Emotion Reporting Technologies and Acceptability of Just-in-Time Content in a Well-being Intervention, Considerations for Scalability and Improved Uptake

et al. 2022

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Researchers increasingly use passive sensing data and frequent self-report to implement personalized mobile health (mHealth) interventions. Yet, we know that certain populations may find these technical protocols burdensome and intervention uptake as well as treatment efficacy may be affected as a result. In the present study, we predicted feasibility (participant adherence to protocol) and acceptability (participant engagement with intervention content) as a function of baseline sociodemographic, mental health, and well-being characteristics of 99 women randomized in the personalized preventive intervention Wellness-for-Two (W-4-2), a randomized trial evaluating stress-related alterations during pregnancy and their effect on infant neurodevelopmental trajectories. The W-4-2 study used ecological momentary assessment (EMA) and wearable electrocardiograph (ECG) sensors to detect physiological stress and personalize the intervention. Participant adherence to protocols was 67% for EMAs and 52% for ECG bio-sensors. Higher baseline negative affect significantly predicted lower adherence to both protocols. Women assigned to the intervention group engaged on average with 42% of content they received. Women with higher annual household income were more likely to engage with more of the intervention content. Researchers should carefully consider tailoring of the intensity of technical intervention protocols to reduce fatigue, especially among participants with higher baseline negative affect, which may improve intervention uptake and efficacy findings at scale.

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“…It is further compounded by the fact that younger and IT-savvy physicians, service developers and entrepreneurs tend to spend more time with the equally IT-literate part of their patient population than with elderly patients with limited IT skills. In some areas, the digital divide may coincide with other divides, such as those of education, wealth or ethnicity [ 89 ]. IT-literate patients are also often over-represented within patient interest groups, leading to a scenario where novel technology may only cater to a part of the population.…”

Section: Challenges Risks and Factors Associated With Successful Impl...mentioning

confidence: 99%

Wearables in Nephrology: Fanciful Gadgetry or Prêt-à-Porter?

Stauss

Htay

Kooman

et al. 2023

Sensors

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Telemedicine and digitalised healthcare have recently seen exponential growth, led, in part, by increasing efforts to improve patient flexibility and autonomy, as well as drivers from financial austerity and concerns over climate change. Nephrology is no exception, and daily innovations are underway to provide digitalised alternatives to current models of healthcare provision. Wearable technology already exists commercially, and advances in nanotechnology and miniaturisation mean interest is also garnering clinically. Here, we outline the current existing wearable technology pertaining to the diagnosis and monitoring of patients with a spectrum of kidney disease, give an overview of wearable dialysis technology, and explore wearables that do not yet exist but would be of great interest. Finally, we discuss challenges and potential pitfalls with utilising wearable technology and the factors associated with successful implementation.

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A cardiovascular clinic patients’ survey to assess challenges and opportunities of digital health adoption during the COVID-19 pandemic

Cited by 11 publications

References 25 publications

Virtual care use among older immigrant adults in Ontario, Canada during the COVID-19 pandemic: A repeated cross-sectional analysis

Virtual care use among older immigrant adults in Ontario, Canada during the COVID-19 pandemic: A repeated cross-sectional analysis

Feasibility of Passive ECG Bio-sensing and EMA Emotion Reporting Technologies and Acceptability of Just-in-Time Content in a Well-being Intervention, Considerations for Scalability and Improved Uptake

Wearables in Nephrology: Fanciful Gadgetry or Prêt-à-Porter?

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