The Relationship between Health Literacy and Comfort with Teleneuropsychology in a Veteran Sample

Abstract

Objective Health literacy is a strong psychosocial determinant of health disparities and has been found to relate to various aspects of health-related technology use. With the increased implementation of neuropsychological services performed via telehealth during the coronavirus disease 2019 pandemic, the relationship between health literacy and comfort with teleneuropsychology warrants further investigation. Method The present study examined 77 Veterans participating in neuropsychological evaluations as a part of standard clinical care. The sample was diverse in terms of age ethnicity, and psychiatric and neurocognitive diagnoses. In addition to a fixed-flexible neuropsychological battery, the Brief Health Literacy Screening Tool (BRIEF) was administered to evaluate health literacy. Self-reported comfort with the teleneuropsychological evaluation was assessed using an informal 10-point scale, and qualitative comfort responses were also recorded. Results Independent samples t-tests revealed older adults were more likely to participate in the evaluation via telephone than with VA Video Connect. Although health literacy was not related to telehealth modality, it was correlated with comfort with the teleneuropsychological evaluation (r = .34, p < .01), although it is notable that average comfort levels were high across modalities (M = 8.16, SD = 2.50). Conclusions Findings support the notion that teleneuropsychological services may feasibly be implemented with a diverse group of patients, although flexibility with modality may be necessary. Those performing these services should also be aware that patients with lower health literacy may feel less comfortable with teleneuropsychology as they seek to build rapport and optimize evaluation engagement.

Telephone-based Frontal Assessment Battery (t-FAB): standardization for the Italian population and clinical usability in neurological diseases

“…TBCS also facilitates the implementation of epidemiological/population-based studies [6], decentralized clinical trials [7] and prevention campaigns [8]. Moreover, at variance with other remote assessment media (e.g., videoconference), the telephone proves to be well accepted by receivers of different socio-demographic backgrounds as requiring minimal digital and health literacy [9,10], being also judged by users as adequate to meet clinical/research questions [9]. It has to be then noted that, as other telehealth practices, TBCS has the potential to reduce the psychosocial burden related to in-person healthcare, weighting not only on patients, but also on their caregivers and professionals carers, which has significantly increased since the onset of the COVID-19 pandemic [11,12].…”

“…a backward digit span (BDS) task[32] (HP subsample of N = 270: 110 males, 160 females; age: 47.24 ± 18.33 years, 18-96; education: 13.67 ± 3.63 years,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]…”

Evaluation of teleneuropsychology services in veterans during COVID-19.

“…In addition to maximizing modality, there may be additional approaches that focus on building rapport and education to patients to increase utilization. For example, given the influence of health literacy on comfort with teleNP (Sullivan-Baca et al, 2022), future studies can evaluate whether an initial psychoeducation during scheduling (e.g., addressing attitudes, beliefs, and/or literacy effects) influences teleNP utilization. In addition to maximizing modality, a tiered approach to assessment can also be considered to increase effectiveness of service delivery.…”

“…Research suggests using teleNP can vary according to the types of referrals, as evidenced by higher rates of teleNP use for neurodegenerative or memory disorders during COVID-19 (Pulsifer et al, 2021). To date, however, evaluation of teleNP services within the VHA has been limited to examining performance validity failures in Veterans with traumatic brain injury (Kanser et al, 2021), the role of patient factors (e.g., sensory difficulties, self-report comfort with technology, health literacy) using full teleNP services, and the role of health literacy in predicting patient comfort with teleNP (Sullivan-Baca et al, 2022). A recent study evaluated the acceptability and satisfaction with teleNP when Veterans were offered a choice between in-person or teleNP (Appleman et al, 2021).…”

Neurodivergence and Inclusivity in Cultural Institutions: A Review of Theories and Best Practices

“…For those with social anxiety issues, stopping at the information center may be too overly welcoming and those visitors miss out on knowing about additional assistance, such as accessing audio guides or printed materials. Individuals must first feel comfortable enough in the environment to approach a front desk to learn about available tools to assist with their visitor experiences, which has been born out in other populations (Li & Ma, 2022;Sullivan-Baca, Babicz, Choudhury, & Miller, 2022). These available materials to support their comfort levels can include:…”