Pandemic-Triggered Adoption of Telehealth in Underserved Communities: Descriptive Study of Pre- and Postshutdown Trends.

BACKGROUND: The adoption of telehealth services has been a challenge in rural communities. The reasons for the slow adoption of such technology-driven services have been attributed to social norms, health care policies, and a lack of infrastructure to support the delivery of services. However, the COVID-19 pandemic-related shutdown of in-person health care services resulted in the usage of telehealth services as a necessity rather than a choice. The pandemic also fast-tracked some needed legislation to allow medical cost reimbursement for remote examination and health care services. As services return to normalcy, it is important to examine whether the usage of telehealth services during the period of a shutdown has changed any of the trends in the acceptance of telehealth as a reliable alternative to traditional in-person health care services. OBJECTIVE: Our aim was to explore whether the temporary shift to telehealth services has changed the attitudes toward the usage of technology-enabled health services in rural communities. METHODS: We examined the Medicaid reimbursement data for the state of Alabama from March 2019 through June 2021. Selecting the telehealth service codes, we explored the adoption rates in 3 phases of the COVID-19 shutdown: prepandemic, pandemic before the rollout of mass vaccination, and pandemic after the rollout of mass vaccination. RESULTS: The trend in telemedicine claims had an opposite pattern to that in nontelemedicine claims across the 3 periods. The distribution of various characteristics of patients who used telemedicine (age group, gender, race, level of rurality, and service provider type) was different across the 3 periods. Claims related to behavior and mental health had the highest rates of telemedicine usage after the onset of the pandemic. The rate of telemedicine usage remained at a high level after the rollout of mass vaccination. CONCLUSIONS: The current trends indicate that adoption of telehealth services is likely to increase postpandemic and that the consumers (patients), service providers, health care establishments, insurance companies, and state and local policies have changed their attitudes toward telehealth. An increase in the use of telehealth could help local and federal governments address the shortage of health care facilities and service providers in underserved communities, and patients can get the much-needed care in a timely and effective manner.

"It's All Just Marketing", a Qualitative Analysis of Consumer Perceptions and Understandings of Nutrition Content and Health Claims in New Zealand.

Nutrition content and health claims are widely used globally on both food labels and in food advertising. This study explored how New Zealand consumers understand, perceive, and use nutrition content and health claims on food labels. A qualitative approach was used with semi-structured in-depth online interviews and in-person focus groups including 49 participants, aged ≥25 years responsible for household food shopping. Transcripts were analysed using reflexive thematic analysis using inductive coding, with development of five themes-(1) aware of claims but did not use, (2) mistrust and scepticism, (3) confusion and misinterpretation, (4) using claims to guide food choice, and (5) not all claims are equal. For theme 1, price and habit were found to be the most influential in driving food choice. Underlying theme 2 was the perception by most of nutrition and health claims as marketing. Scepticism was exacerbated when nutrient claims were displayed on inherently unhealthy products. However participants with specific dietary requirements did find claims helpful. Restricting nutrient claims to foods meeting a healthy nutrient profile aligned to the existing Health Star Rating system, education about regulation and supporting claims with more contextual information may increase trust, the perceived value of claims and therefore their utility.