Ensuring Equity and Inclusion in Virtual Care Best Practices for Diverse Populations of Youth with Chronic Pain

Abstract

Poor access to care is a top patient-oriented research priority for youth with chronic pain in Canada, and the COVID-19 pandemic has exacerbated these concerns. Our patientoriented project team engaged with marginalized and racialized youth with chronic pain (Black youth with sickle cell disease, Indigenous youth and youth with complex medical needs) and their families to ensure that best practice recommendations for virtual care are inclusive and equitable. Input provided through virtual round-table discussions improved recommendations for leveraging, implementing and selecting best platforms for virtual care for youth with chronic pain and identified new gaps for future research, practice and policy change. P = Patient partner.

Immigrant, Refugee, and Indigenous Canadians’ Experiences With Virtual Health Care Services: Rapid Review

“…The included studies comprised review articles [ 33 , 34 , 38 ], focus groups or interviews [ 31 , 32 , 37 ], and 1 cohort study with a mixed methods design [ 35 ]. Specific virtual care services included call centers providing health-related information to immigrant populations [ 32 ], SMS text messaging for Indigenous youths who use illicit drugs [ 35 ], assistive technologies for aging in place [ 34 ], and more broad virtual care services for individuals with diabetes [ 33 ], chronic pain [ 36 ], and mental health conditions [ 31 , 37 ].…”

“…Increased access to services [ 31 , 35 ]. Decreased health care cost [ 31 , 36 - 38 ] and travel time [ 36 - 38 ]…”

Can sharing improve caring? A call to prioritize shared decision making in pediatric pain management.

“…Even where complexity exists, opportunities to engage young patients should consistently be offered. especially in the context of pediatric pain, where youth from equity-seeking groups have reported a desire to be engaged in SDM with caregivers and HCPs to determine the best option for their treatment (Birnie et al, 2022).…”

Empowering and Accelerating Impacts of Patient-Oriented Research

“…Patient partnership, however, has been challenged as a result of the COVID-19 pandemic, along with exacerbation of social inequities in health (Sayani et al 2021). While equity is a recurring theme in this special issue, the Birnie et al (2022a) and Vanderhout et al (2022) projects emphasize inclusivity and equity for patient engagement and research impacts in response to the pandemic.…”

“…One of the major impacts of COVID-19 restrictions in healthcare was the transition from in-person visits to virtual care. Recognizing that certain marginalized communities (e.g., People of Colour, Indigenous Peoples) were excluded from pain services and research, combined with the potential of virtual care to exacerbate health inequities, Birnie et al (2022a) engaged with a diverse group of youths living with chronic pain and their families to develop best practice recommendations for virtual care. While the project identified opportunities for virtual care to reduce stigma, bias and discrimination, it also described key gaps, including lack of reliable Internet access and challenges associated with virtual delivery environments (e.g., access to private settings for visits).…”