Pediatric Telehealth Access and Utilization in Chicago During the First Year of the COVID-19 Pandemic

Kronforst, Kenny; Barrera, Leonardo; Casale, Mia T.; Smith, Tracie L.; Schinasi, Dana Aronson; Macy, Michelle L.

doi:10.1089/tmj.2022.0481

Cited by 4 publications

(11 citation statements)

References 28 publications

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“…No other participant characteristic was consistently associated with poorer technology use and related outcomes. These quantitative findings are similar to other studies revealing disparities in telehealth use, including among Latinx individuals and pediatric patients 17 …”

Section: Discussionsupporting

confidence: 91%

“…These quantitative findings are similar to other studies revealing disparities in telehealth use, including among Latinx individuals and pediatric patients. 17 Our qualitative findings further revealed study participants who used the portal and video appointments were pleased with them. The majority explained they find the technologies convenient and efficient, particularly for scheduling appointments and viewing lab results.…”

Section: Discussionmentioning

confidence: 63%

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Optimizing Telehealth Services

Pack,

Rusca,

Llaneza

et al. 2023

Medical Care

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Background: The COVID-19 pandemic increased telehealth services in federally funded community health centers (CHCs). Yet little is known about common determinants of use among CHC patients. Objective: We examined the use of telehealth among patient participants at 1 large CHC network providing care to underserved populations at urban and suburban sites in the Midwest. Methods: We conducted a mixed-methods study utilizing a sequential explanatory design. Participants were English and/or Spanish-speaking adults who attended ≥1 visits for themselves or their child over a 12-month period at any practice location. Research staff conducted a structured phone survey of eligible adults. The results subsequently facilitated purposive sampling of telehealth “users” and “nonusers” for qualitative phone interviews. Results: The survey participants included 500 adults. Most had access to the resources needed to utilize telehealth, including a smartphone (90.4%) and home internet (83.0%). About half (50.8%) “rarely or never” had problems with internet speed, reliability, or quality. Most (81.1%) were aware of the patient portal and 59.8% had utilized video visits. Participants who were Spanish-speaking and with limited English proficiency faced some of the greatest barriers. Qualitative interview participants included 12 users and 12 nonusers of telehealth. Users found telehealth convenient and efficient, while nonusers lacked awareness about how telehealth services could be beneficial or needed assistance to sign up, join, or use telehealth. Conclusions: Most participants had the resources and awareness necessary to use telehealth services. Those who use them appreciate the convenience and efficiency. Nevertheless, additional support may be needed to prevent telehealth from exacerbating health inequities.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 63%

Optimizing Telehealth Services

Pack,

Rusca,

Llaneza

et al. 2023

Medical Care

View full text Add to dashboard Cite

show abstract

“…Video visits were lowest among those without a high school diploma, non-Latino Asian, and non-Latino Black individuals ( 42 ). In a study of pediatric telehealth in Chicago, incomplete video visit rates were associated with lower broadband access ( 43 ). To enhance satisfaction, increasing access to reliable Internet services and technological devices will be valuable.…”

Section: Discussionmentioning

confidence: 99%

Satisfaction with pediatric telehealth according to the opinions of children and adolescents during the COVID-19 pandemic: A literature review

Kodjebacheva

Culinski

Kawser

et al. 2023

Front. Public Health

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ObjectiveTo review satisfaction with telehealth among children and adolescents based on their own opinions during the COVID-19 pandemic.MethodsIn the PubMed, CINAHL, PsycINFO, and Embase databases, we searched for peer-reviewed studies in English on satisfaction with telehealth among children and adolescents (rather than parents). Both observational studies and interventions were eligible. The review was categorized as a mini review because it focused on the limited time frame of the COVID-19 pandemic. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Reviewers extracted information from each study and assessed risk of bias.ResultsA total of 14 studies were eligible. Studies were conducted in Australia, Canada, Italy, Israel, Poland, South Korea, the United Kingdom, and the United States. They focused on a variety of health conditions. Two of the 14 studies were interventions. Participants expressed high satisfaction with video and telephone visits and home telemonitoring while also preferring a combination of in-person visits and telehealth services. Factors associated with higher satisfaction with telehealth included greater distance from the medical center, older age, and lower anxiety when using telehealth. In qualitative studies, preferred telehealth features among participants included: a stable Internet connection and anonymity and privacy during telehealth visits.ConclusionTelehealth services received favorable satisfaction ratings by children and adolescents. Randomized-controlled trials on the effectiveness of pediatric telehealth services compared to non-telehealth services may assess improvements in satisfaction and health outcomes.

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“…The net results are worse aggregate health outcomes and a greater overall economic burden. [1][2][3][4][5][6][7] Data collected during the COVID-19 pandemic revealed even higher MCV rates among racially, ethnically, and economically…”

mentioning

confidence: 99%

“…Cross-study comparisons have been limited by using interpreter requests as a proxy for language fluency, limited language comparison (often limited to English vs. Spanish), or grouping languages other than English to achieve statistical significance. 1,[4][5][6][7]9,[11][12][13][14][15] Similarly, fewer studies have assessed the associations between patient-preferred languages and MCV occurrence for pediatric patients utilizing telemedicine. 7,9,14,15 Characterization of these associations, particularly within the context of other clinic structural and sociodemographic predictors in the present post-COVID telehealth expansion, is critical to developing equitable clinical care initiatives for children with acute and chronic illnesses.…”

mentioning

confidence: 99%

Analysis of missed clinic visits, preferred languages, and telemedicine in a pediatric gastroenterology practice

Crume,

Suufi,

Nabbosa

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesPrevious studies have demonstrated a relationship between socioeconomic disparities and missed clinic visits (MCV). However, the relationship between patient‐preferred language and MCVs, particularly with respect to telemedicine, remains relatively underexplored. We sought to characterize the associations between MCV and patient‐level predictors, including preferred language, in a large single‐center pediatric gastroenterology, hepatology, and nutrition practice.MethodsThis retrospective longitudinal cohort study included all missed or completed outpatient visits in the Gastroenterology, Hepatology, and Nutrition Programs at Boston Children's Hospital from January 1, 2016 to May 20, 2022. Univariate and multivariate hierarchical generalized linear mixed models were employed to identify associations between visit‐ and patient‐level predictors and an MCV outcome.ResultsA total of 300,201 visits from 70,710 patients residing in Massachusetts were included. Univariate analyses revealed higher MCV odds for Hispanic patients and those from areas with the highest Social Vulnerability Index (SVI), and these odds increased with telemedicine (Hispanic in‐person odds ratio [OR] 5.21 [(95% confidence interval) 4.93–5.52] vs. telemedicine OR 8.79 [7.85–9.83]; highest SVI in‐person OR 5.28 [4.95–5.64] vs. telemedicine OR 7.82 [6.84–8.96]). Controlled multivariate analyses revealed that among six language groups, only Spanish language preference was associated with higher MCV odds, which increased with telemedicine (Spanish in‐person adjusted OR [aOR] 1.35 [1.24–1.48] vs. telemedicine aOR 2.1 [1.83–2.44]).ConclusionsPatients preferring Spanish experience unique barriers to care beyond those faced by other language preference groups, and telemedicine may exacerbate these barriers.

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Pediatric Telehealth Access and Utilization in Chicago During the First Year of the COVID-19 Pandemic

Cited by 4 publications

References 28 publications

Optimizing Telehealth Services

Optimizing Telehealth Services

Satisfaction with pediatric telehealth according to the opinions of children and adolescents during the COVID-19 pandemic: A literature review

Analysis of missed clinic visits, preferred languages, and telemedicine in a pediatric gastroenterology practice

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