Factors Associated with Telehealth Utilization among Older African Americans in South Los Angeles during the COVID-19 Pandemic

Abstract

Background: The COVID-19 pandemic transformed healthcare delivery with the expansive use of telemedicine. However, health disparities may result from lower adoption of telehealth among African Americans. This study examined how under-resourced, older African Americans with chronic illnesses use telehealth, including related sociodemographic and COVID-19 factors. Methods: Using a cross-sectional design, 150 middle-aged and older African Americans were recruited from faith-based centers from March 2021 to August 2022. Data collected included sociodemographics, comorbidities, technological device ownership, internet usage, and attitudes toward COVID-19 disease and vaccination. Descriptive statistics and multivariable regression models were conducted to identify factors associated with telehealth use. Results: Of the 150 participants, 32% had not used telehealth since the COVID-19 pandemic, with 75% reporting no home internet access and 38% having no cellular/internet network on their mobile device. Age, access to a cellular network on a mobile device, and wireless internet at home were significantly associated with the utilization of telehealth care. Higher anxiety and stress with an increased perceived threat of COVID-19 and positive attitudes toward COVID-19 vaccination were associated with telehealth utilization. Discussion: Access and integration of telehealth services were highlighted as challenges for this population of African Americans. To reduce disparities, expansion of subsidized wireless internet access in marginalized communities is necessitated. Education outreach and training by healthcare systems and community health workers to improve uptake of telehealth currently and post-COVID-19 should be considered.

Diet Quality of Older African Americans: Impact of Knowledge and Perceived Threat of COVID-19

“…Participants : We analyzed data from the COVID-19, Food Insecurity, Exercise and Diet (C-FED) study. The C-FED study was a cross-sectional ‘add-on’ component to a larger intervention among older African American parishioners living in an underserved and under-resourced area of South Los Angeles [ 28 , 29 ]. Participants were eligible for recruitment if they were African American adults aged 65 years or older, or aged 55–64 years with a chronic medical condition.…”

Mobilizing faith-based COVID-19 health ambassadors to address COVID-19 health disparities among African American older adults in under-resourced communities: A hybrid, community-based participatory intervention

“…The CDC "scaling up operation" recommends that faith-based organizations (FBOs) establish and maintain communication with local authorities and work closely with health organizations to implement COVID-19 guidelines effectively [22]. Telehealth methods had been suggested as an innovative approach to delivering healthcare services to vulnerable populations, such as AAs, who experience disparities in accessing and maintaining healthcare services [48][49][50]. AA churches have historically supported their families economically, spiritually, socially, and culturally through programs that are unmatched by other social institutions [20].…”