April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: Telehealth Utilization, Preferences and Barriers in Underserved Rural Settings: A Mixed Methods Study
Background: Telehealth approaches can mitigate healthcare access challenges that contribute to persistent rural health inequities. The lack of knowledge about specific barriers and preferences for telehealth limits the ability to implement acceptable telehealth approaches in rural regions. Thus, the purpose of this study was to conduct a formative evaluation to identify barriers and facilitators for implementing telehealth programs in underserved rural settings.
Methods: Using a mixed-methods design, we distributed anonymous and voluntary surveys and conducted in-depth semi-structured interviews assessing telehealth utilization, preferences, and barriers among community stakeholders in rural Michigan. The survey was informed by the Unified Theory of Acceptance and Use of Technology model and assessed telehealth utilization, perceptions of use, technology access and barriers using Likert-type response scale (1=strongly agree to 5=strongly disagree). We used descriptive statistics and qualitative thematic analysis to characterize survey and interview data, respectively.
Findings: Survey respondents (n=59) were primarily female (73.2%), and White (73.2%) with 51.8% reporting an annual income <$20,000 USD, and 18.6% indicating no internet access in their homes. The mean age of respondents was 61 years. Overall, 59.3% of survey respondents had heard about telemedicine and 42.4% had used telemedicine in the past. Perceptions of telehealth among users were generally favorable, with 61.9% reporting satisfaction with telemedicine visits and 71.4% agreeing or strongly agreeing that they were able to communicate adequately with the health care provider using telemedicine. Reported barriers to telehealth included limited internet connectivity (72.8%), technology challenges (66.6%), and lack of knowledge on how to access telemedicine care (62.5%). Interview participants (n=8) noted convenience of telehealth in overcoming transportation barriers but described limited access to the internet as a barrier to utilization.
Implications: Findings from this study suggest the need to to increase internet access and promote digital literacy to ensure the equitable implementation of technology approaches to address rural health disparities. Results from this study provide specific community-driven recommendations to inform the implementation of acceptable telehealth approaches in rural settings. This research also provides a replicable and scalable model to inform telehealth implementation efforts in other under-resourced settings.
Methods: Using a mixed-methods design, we distributed anonymous and voluntary surveys and conducted in-depth semi-structured interviews assessing telehealth utilization, preferences, and barriers among community stakeholders in rural Michigan. The survey was informed by the Unified Theory of Acceptance and Use of Technology model and assessed telehealth utilization, perceptions of use, technology access and barriers using Likert-type response scale (1=strongly agree to 5=strongly disagree). We used descriptive statistics and qualitative thematic analysis to characterize survey and interview data, respectively.
Findings: Survey respondents (n=59) were primarily female (73.2%), and White (73.2%) with 51.8% reporting an annual income <$20,000 USD, and 18.6% indicating no internet access in their homes. The mean age of respondents was 61 years. Overall, 59.3% of survey respondents had heard about telemedicine and 42.4% had used telemedicine in the past. Perceptions of telehealth among users were generally favorable, with 61.9% reporting satisfaction with telemedicine visits and 71.4% agreeing or strongly agreeing that they were able to communicate adequately with the health care provider using telemedicine. Reported barriers to telehealth included limited internet connectivity (72.8%), technology challenges (66.6%), and lack of knowledge on how to access telemedicine care (62.5%). Interview participants (n=8) noted convenience of telehealth in overcoming transportation barriers but described limited access to the internet as a barrier to utilization.
Implications: Findings from this study suggest the need to to increase internet access and promote digital literacy to ensure the equitable implementation of technology approaches to address rural health disparities. Results from this study provide specific community-driven recommendations to inform the implementation of acceptable telehealth approaches in rural settings. This research also provides a replicable and scalable model to inform telehealth implementation efforts in other under-resourced settings.