Racial and ethnic differences in self-reported telehealth use during the COVID-19 pandemic: a secondary analysis of a US survey of internet users from late March

Campos-Castillo, Celeste; Anthony, Denise L.

doi:10.1093/jamia/ocaa221

Cited by 127 publications

(128 citation statements)

References 30 publications

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“…With the seriousness of the pandemic, preferences for a psychiatric visit type based on sex may have had less impact; this may also be true for race. Compared to other studies [16,21], our sample revealed no divide in selection of visit type with regard to patient race. This may stem from our cohort being predominantly White.…”

Section: Xsl • Focontrasting

confidence: 57%

Factors Influencing Patients’ Initial Decisions Regarding Telepsychiatry Participation During the COVID-19 Pandemic: Telephone-Based Survey

Severe¹,

Tang²,

Horbatch³

et al. 2020

JMIR Form Res

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Background Telepsychiatry enables patients to establish or maintain psychiatric care during the COVID-19 pandemic. Little is known about the factors influencing patients’ initial decisions to participate in telepsychiatry in the midst of a public health crisis. Objective This paper seeks to examine factors influencing patients’ initial decisions to accept or decline telepsychiatry immediately after the stay-at-home order in Michigan, their initial choice of virtual care modality (video or telephone), and their anticipated participation in telepsychiatry once clinics reopen for in-person visits. Methods Between June and August 2020, we conducted a telephone-based survey using a questionnaire comprising 14 quantitative and two qualitative items as part of a quality improvement initiative. We targeted patients who had an in-person appointment date that fell in the first few weeks following the Michigan governor’s stay-at-home order, necessitating conversion to virtual visits or deferment of in-person care. We used descriptive statistics to report individual survey responses and assess the association between chosen visit type and patient characteristics and future participation in telepsychiatry using multivariable logistic regression. Results A total of 244 patients whose original in-person appointments were scheduled within the first 3 weeks of the stay-at-home order in Michigan completed the telephone survey. The majority of the 244 respondents (n=202, 82.8%) initially chose to receive psychiatric care through video visits, while 13.5% (n=33) chose telephone visits and 1.2% (n=3) decided to postpone care until in-person visit availability. Patient age correlated with chosen visit type (P<.001; 95% CI 0.02-0.06). Patients aged ≥44 years were more likely than patients aged 0-44 years to opt for telephone visits (relative risk reduction [RRR] 1.2; 95% CI 1.06-1.35). Patient sex (P=.99), race (P=.06), type of insurance (P=.08), and number of previous visits to the clinic (P=.63) were not statistically relevant. Half of the respondents (132/244, 54.1%) stated theywere likely to continue with telepsychiatry even after in-person visits were made available. Telephone visit users were less likely than video visit users to anticipate future participation in telepsychiatry (RRR 1.08; 95% CI 0.97-1.2). Overall, virtual visits met or exceeded expectations for the majority of users. Conclusions In this cohort, patient age correlates with the choice of virtual visit type, with older adults more likely to choose telephone visits over video visits. Understanding challenges to patient-facing technologies can help advance health equity and guide best practices for engaging patients and families through telehealth.

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Section: Xsl • Focontrasting

confidence: 57%

Factors Influencing Patients’ Initial Decisions Regarding Telepsychiatry Participation During the COVID-19 Pandemic: Telephone-Based Survey

Severe¹,

Tang²,

Horbatch³

et al. 2020

JMIR Form Res

View full text Add to dashboard Cite

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“…Some initiatives have also been based on the development of surveys to thoroughly analyze the causes of the Digital Divide [ 13 , 14 , 15 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The racial and ethnic differences in the areas of remote assistance during the COVID-19 pandemic [ 17 ].…”

Section: Purpose Of the Studymentioning

confidence: 99%

The Digital Divide in the Era of COVID-19: An Investigation into an Important Obstacle to the Access to the mHealth by the Citizen

Giansanti

Veltro

2021

Healthcare

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In general, during the COVID-19 pandemic there has been a growth in the use of digital technological solutions in many sectors, from that of consumption, to Digital Health and in particular to mobile health (mHealth) where an important role has been played by mobile technology (mTech). However, this has not always happened in a uniform way. In fact, in many cases, citizens found themselves unable to take advantage of these opportunities due to the phenomenon of the Digital Divide (DD). It depends on multifaceted aspects ranging from the lack of access to instrumental and network resources, to cultural and social barriers and also to possible forms of communication disability. In the study we set ourselves the articulated goal of developing a probing methodology that addresses the problems connected to DD in a broad sense, capable of minimizing the bias of a purely electronic submission and evaluating its effectiveness and outcome. At the moment, we have submitted the survey both electronically (with an embedded solution to spread it inside the families/acquaintances) and using the wire phone. The results highlighted three polarities (a) the coherence of the two methods; (b) the outcome of the entire submission in relation to key issues (e.g., familiarity on contact tracing Apps, medical Apps, social Apps, messaging Apps, Digital-health, non-medical Apps); (c) a Digital Divide strongly dependent on age and in particular for the elderly is mainly evident in the use of mTech in general and in particular in mHealth applications. Future developments of the study foresee, after adequate data-mining, an in-depth study of all the aspects proposed in the survey, from those relating to access to resources, training, disability and other cultural factors.

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“…2 Finally, though over 90% of the population is White, most racial and ethnic groups are represented, including the American Indian Nations and tribal communities of Wisconsin. 19 Previous studies presented changes in the scale and applications of telemedicine use during the first wave of the pandemic, which occurred around March to May of 2020, [20][21][22][23][24][25] as well as the utility of telemedicine in treating cases of suspected COVID-19. 24,26,27 Few studies thus far have examined telemedicine utilization patterns after May 2020, as outpatient telemedicine delivery grew more widespread.…”

Section: Background and Significancementioning

confidence: 99%

Disparities in Telemedicine Access: A Cross-Sectional Study of a Newly Established Infrastructure during the COVID-19 Pandemic

et al. 2021

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Background The COVID-19 pandemic led to dramatic increases in telemedicine use to provide outpatient care without in-person contact risks. Telemedicine increases options for health care access, but a “digital divide” of disparate access may prevent certain populations from realizing the benefits of telemedicine. Objectives The study aimed to understand telemedicine utilization patterns after a widespread deployment to identify potential disparities exacerbated by expanded telemedicine usage. Methods We performed a cross-sectional retrospective analysis of adults who scheduled outpatient visits between June 1, 2020 and August 31, 2020 at a single-integrated academic health system encompassing a broad range of subspecialties and a large geographic region in the Upper Midwest, during a period of time after the initial surge of COVID-19 when most standard clinical services had resumed. At the beginning of this study period, approximately 72% of provider visits were telemedicine visits. The primary study outcome was whether a patient had one or more video-based visits, compared with audio-only (telephone) visits or in-person visits only. The secondary outcome was whether a patient had any telemedicine visits (video-based or audio-only), compared with in-person visits only. Results A total of 197,076 individuals were eligible (average age = 46 years, 56% females). Increasing age, rural status, Asian or Black/African American race, Hispanic ethnicity, and self-pay/uninsured status were significantly negatively associated with having a video visit. Digital literacy, measured by patient portal activation status, was significantly positively associated with having a video visit, as were Medicaid or Medicare as payer and American Indian/Alaskan Native race. Conclusion Our findings reinforce previous evidence that older age, rural status, lower socioeconomic status, Asian race, Black/African American race, and Hispanic/Latino ethnicity are associated with lower rates of video-based telemedicine use. Health systems and policies should seek to mitigate such barriers to telemedicine when possible, with efforts such as digital literacy outreach and equitable distribution of telemedicine infrastructure.

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Racial and ethnic differences in self-reported telehealth use during the COVID-19 pandemic: a secondary analysis of a US survey of internet users from late March

Cited by 127 publications

References 30 publications

Factors Influencing Patients’ Initial Decisions Regarding Telepsychiatry Participation During the COVID-19 Pandemic: Telephone-Based Survey

Factors Influencing Patients’ Initial Decisions Regarding Telepsychiatry Participation During the COVID-19 Pandemic: Telephone-Based Survey

The Digital Divide in the Era of COVID-19: An Investigation into an Important Obstacle to the Access to the mHealth by the Citizen

Disparities in Telemedicine Access: A Cross-Sectional Study of a Newly Established Infrastructure during the COVID-19 Pandemic

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