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2.
J Am Coll Surg ; 234(2): 191-202, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1713819

ABSTRACT

BACKGROUND: Surgical patients with limited digital literacy may experience reduced telemedicine access. We investigated racial/ethnic and socioeconomic disparities in telemedicine compared with in-person surgical consultation during the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN: Retrospective analysis of new visits within the Division of General & Gastrointestinal Surgery at an academic medical center occurring between March 24 through June 23, 2020 (Phase I, Massachusetts Public Health Emergency) and June 24 through December 31, 2020 (Phase II, relaxation of restrictions on healthcare operations) was performed. Visit modality (telemedicine/phone vs in-person) and demographic data were extracted. Bivariate analysis and multivariable logistic regression were performed to evaluate associations between patient characteristics and visit modality. RESULTS: During Phase I, 347 in-person and 638 virtual visits were completed. Multivariable modeling demonstrated no significant differences in virtual compared with in-person visit use across racial/ethnic or insurance groups. Among patients using virtual visits, Latinx patients were less likely to have video compared with audio-only visits than White patients (OR, 0.46; 95% CI 0.22-0.96). Black race and insurance type were not significant predictors of video use. During Phase II, 2,922 in-person and 1,001 virtual visits were completed. Multivariable modeling demonstrated that Black patients (OR, 1.52; 95% CI 1.12-2.06) were more likely to have virtual visits than White patients. No significant differences were observed across insurance types. Among patients using virtual visits, race/ethnicity and insurance type were not significant predictors of video use. CONCLUSION: Black patients used telemedicine platforms more often than White patients during the second phase of the COVID-19 pandemic. Virtual consultation may help increase access to surgical care among traditionally under-resourced populations.


Subject(s)
COVID-19/epidemiology , General Surgery/statistics & numerical data , Office Visits/statistics & numerical data , Pandemics , Telemedicine/statistics & numerical data , Adult , Aged , Ambulatory Surgical Procedures , Computer Literacy , Female , Health Services Accessibility/statistics & numerical data , Humans , Insurance Coverage/statistics & numerical data , Logistic Models , Male , Massachusetts/epidemiology , Middle Aged , Public Health , Retrospective Studies , Socioeconomic Factors , Telephone/statistics & numerical data
4.
J Pediatr ; 237: 115-124.e2, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1281471

ABSTRACT

OBJECTIVES: To determine whether telehealth acceptance by parents of children with heart disease is predicted by sociodemographic and/or by parental digital literacy, and to assess parental perceptions of telehealth usability and reliability. STUDY DESIGN: We conducted a single center study comparing telehealth acceptance versus visit cancellation/rescheduling for pediatric cardiology visits during the early phase of the COVID-19 pandemic. All parent/guardians who consented to survey completion received a validated survey assessing their digital literacy. Consenting parents who accepted telehealth received an additional validated survey assessing their perceptions of telehealth usability and reliability. RESULTS: A total of 849 patients originally were scheduled for in-person visits between March 30 and May 8, 2020. Telehealth acceptance was highest among younger, publicly insured, Hispanic patients with primary diagnoses of arrhythmia/palpitations, chest pain, dysautonomia, dyslipidemia and acquired heart disease. Among parents who completed surveys, a determinant of telehealth acceptance was digital literacy. Telehealth was determined to be a usable and reliable means for health care delivery. CONCLUSION: Although the potential for inequitable selection of telehealth due to sociodemographic factors exists, we found that such factors were not a major determinant for pediatric cardiology care within a large, diverse, free-standing pediatric hospital.


Subject(s)
Computer Literacy/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Social Determinants of Health/statistics & numerical data , Telemedicine/organization & administration , Adolescent , COVID-19/epidemiology , Cardiology/organization & administration , Child , Child, Preschool , Female , Humans , Male , Pandemics , Parents , SARS-CoV-2 , Surveys and Questionnaires
5.
J Med Syst ; 45(7): 72, 2021 Jun 05.
Article in English | MEDLINE | ID: covidwho-1258233

ABSTRACT

There is a rapidly evolving need for e-health to support chronic disease self-management and connect patients with their healthcare teams. Patients with cirrhosis have a high symptom burden, significant comorbidities, and a range of psychological and cognitive issues. Patients with cirrhosis were assessed for their readiness and interest in e-health. Adults attending one of two outpatient cirrhosis clinics in Alberta were recruited. Eligible participants were not required to own or have experience with digital technologies or the Internet. Medical history, socioeconomic status, and attitudes regarding e-health, the Computer Proficiency Questionnaire, and the Mobile Device Proficiency Questionnaire were used to describe participants' knowledge and skills. Of the 117 recruited patients, 68.4% owned a computer and 84.6% owned a mobile device. Patients had mean proficiency scores of 72.8% (SD 25.9%) and 69.3% (SD 26.4%) for these devices, respectively. In multiple regression analyses, significant predictors of device proficiency were age, education, and household income. Most patients (78.7%) were confident they could participate in videoconferencing after training and most (61.5%) were interested in an online personalized health management program. This diverse group of patients with cirrhosis had technology ownership, proficiency, and online behaviours similar to the general population. Moreover, the patients were very receptive to e-health if training was provided. This promising data is timely given the unique demands of COVID-19 and its influence on self-management and healthcare delivery to a vulnerable population.


Subject(s)
Computer Literacy , Internet , Liver Cirrhosis , Technology , Telemedicine , Adult , Aged , Alberta , COVID-19 , Female , Humans , Male , Middle Aged , Patient Preference
6.
J Appl Gerontol ; 40(9): 958-962, 2021 09.
Article in English | MEDLINE | ID: covidwho-1226831

ABSTRACT

While U.S. adults living in affordable senior housing represent a vulnerable population during the COVID-19 pandemic, affordable housing may provide a foundation for interventions designed to improve technology access to support health. To better understand technology access among residents of affordable senior housing, we surveyed members of a national association of resident service coordinators to assess their experiences working with residents during the pandemic (n = 1,440). While nearly all service coordinators report that most or all residents have reliable phone access, under a quarter report that most or all have reliable internet access; they also report limited access to technology for video calls. Lack of internet access and technology literacy are perceived as barriers to medical visits and food procurement for low-income older adult residents of affordable housing. Policies to expand internet access as well as training and support to enable use of online services are required to overcome these barriers.


Subject(s)
Cell Phone Use/statistics & numerical data , Communication Barriers , Homes for the Aged , Internet Access/statistics & numerical data , Nursing Homes , Videoconferencing , Aged , COVID-19 , Computer Literacy , Female , Health Services Accessibility , Homes for the Aged/economics , Homes for the Aged/statistics & numerical data , Humans , Internet Use/statistics & numerical data , Male , Nursing Homes/economics , Nursing Homes/statistics & numerical data , SARS-CoV-2 , United States/epidemiology , Videoconferencing/statistics & numerical data , Videoconferencing/supply & distribution , Vulnerable Populations
7.
Front Public Health ; 9: 577079, 2021.
Article in English | MEDLINE | ID: covidwho-1201520

ABSTRACT

Older individuals are at an increased risk of experiencing adverse social and health consequences due to both the COVID-19 pandemic and the measures taken to manage it, such as social distancing. To promote community-dwelling older individuals' well-being during this time, the aims of the current project are to develop effective strategies in order (a) to increase older individuals' digital literacy, and (b) to help them acquire behavioral and cognitive skills that will improve their coping abilities with the stressful situation created as a result of the pandemic, as well as reducing adverse mental health effects. The project comprises an intervention arm that includes digital group sessions for older individuals meant to improve their digital literacy, promote their effective coping, and relieve their mental distress and loneliness. Subjects receive a short-term (seven sessions), twice-weekly, digitally guided group intervention through Zoom (a video conferencing app), and WhatsApp (instant messaging app). The wait list control-group participants receive twice-weekly telephone calls from a research assistant during a parallel period. Web-based questionnaires are filled in pre- and post-participation. The effectiveness of the intervention will be analyzed by comparing pre- and post-measures, between intervention and control groups. This protocol offers a model for helping to support vulnerable populations during the COVID-19 pandemic. However, it is applicable regardless of the outbreak of a global health crisis or the imposition of lockdown rules; in fact, it has the potential to contribute to the social inclusion of vulnerable populations during routine times as well as during emergencies. Furthermore, ideas for future expansion include the integration of multilingual facilitators in order to reach seniors from underserved minority groups in various social contexts, even across borders.


Subject(s)
Adaptation, Psychological , COVID-19/psychology , Health Promotion , Pandemics , Psychological Distress , Aged , Communicable Disease Control , Computer Literacy , Disease Outbreaks , Humans , Independent Living , Internet , Mobile Applications , Prospective Studies
8.
J Appl Gerontol ; 40(9): 953-957, 2021 09.
Article in English | MEDLINE | ID: covidwho-1177693

ABSTRACT

This study explored older adults' technology use patterns and attitudes toward virtual volunteering during the COVID-19 pandemic. A 22-item survey was administered to 229 volunteers in the St. Louis region who tutor children through the Oasis Intergenerational Tutoring program. Although most respondents are familiar with technology and expressed that they are likely to volunteer virtually, their responses varied significantly by age, education, gender, income, and school districts. Some tutors expressed that virtual volunteering may eliminate barriers to in-person volunteering, while others were concerned with establishing a personal connection with students online. These findings suggest that tutors anticipate both benefits and challenges with virtual volunteering and that efforts to engage older adults during the pandemic should factor in prior use of technology and ensure that different subgroups are not marginalized.


Subject(s)
Attitude , COVID-19 , Computer Literacy , Education, Distance/methods , Educational Technology/methods , Social Participation/psychology , Teaching , Volunteers/psychology , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Female , Humans , Intergenerational Relations , Interpersonal Relations , Male , Missouri , Teaching/psychology , Teaching/statistics & numerical data , Videoconferencing/instrumentation
9.
World J Gastroenterol ; 26(29): 4182-4197, 2020 Aug 07.
Article in English | MEDLINE | ID: covidwho-1146681

ABSTRACT

Mobile health apps (MHAs) and medical apps (MAs) are becoming increasingly popular as digital interventions in a wide range of health-related applications in almost all sectors of healthcare. The surge in demand for digital medical solutions has been accelerated by the need for new diagnostic and therapeutic methods in the current coronavirus disease 2019 pandemic. This also applies to clinical practice in gastroenterology, which has, in many respects, undergone a recent digital transformation with numerous consequences that will impact patients and health care professionals in the near future. MHAs and MAs are considered to have great potential, especially for chronic diseases, as they can support the self-management of patients in many ways. Despite the great potential associated with the application of MHAs and MAs in gastroenterology and health care in general, there are numerous challenges to be met in the future, including both the ethical and legal aspects of applying this technology. The aim of this article is to provide an overview of the current status of MHA and MA use in the field of gastroenterology, describe the future perspectives in this field and point out some of the challenges that need to be addressed.


Subject(s)
Gastroenterology/methods , Mobile Applications , Self-Management , Telemedicine , Wearable Electronic Devices , Betacoronavirus , COVID-19 , Computer Literacy , Computer Security , Coronavirus Infections/epidemiology , Delivery of Health Care , Electronic Health Records , Ethics, Medical , Health Behavior , Humans , Pandemics , Patient Education as Topic , Physician-Patient Relations , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Smartphone
10.
Invest Educ Enferm ; 39(1)2021 Feb.
Article in English | MEDLINE | ID: covidwho-1123988

ABSTRACT

OBJECTIVES: To understand changes in daily life emerging from the COVID-19 Pandemic in people with visual impairment from four cities of Colombia. METHODS: Exploratory-type, descriptive qualitative study. The study conducted 26 semi-structured interviews via telephone. The analysis process used the methodological design from the approach proposed by Taylor and Bogdan: following the discovery process, coding and relativizing of data. RESULTS: Three categories emerge: 1) Transformations in daily dynamics, 2) Barriers to mobility, and 3) Use of technology. CONCLUSIONS: People with visual impairment report barriers to mobility to take public transportation, which can affect maintenance of their autonomy and independence. Using technological tools is identified as facilitators for the continuity of educational and work activities; however, some did not have computer literacy or the basic inputs for connectivity. Difficulties were identified to continue work activities and maintain income.


Subject(s)
COVID-19 , Mobility Limitation , Personal Autonomy , Vision Disorders/epidemiology , Adult , Aged , Colombia , Computer Literacy , Female , Humans , Internet , Interviews as Topic , Male , Middle Aged , Young Adult
14.
J Med Internet Res ; 23(1): e23805, 2021 01 07.
Article in English | MEDLINE | ID: covidwho-1013294

ABSTRACT

BACKGROUND: Misinformation about COVID-19 is common and has been spreading rapidly across the globe through social media platforms and other information systems. Understanding what the public knows about COVID-19 and identifying beliefs based on misinformation can help shape effective public health communications to ensure efforts to reduce viral transmission are not undermined. OBJECTIVE: This study aimed to investigate the prevalence and factors associated with COVID-19 misinformation in Australia and their changes over time. METHODS: This prospective, longitudinal national survey was completed by adults (18 years and above) across April (n=4362), May (n=1882), and June (n=1369) 2020. RESULTS: Stronger agreement with misinformation was associated with younger age, male gender, lower education level, and language other than English spoken at home (P<.01 for all). After controlling for these variables, misinformation beliefs were significantly associated (P<.001) with lower levels of digital health literacy, perceived threat of COVID-19, confidence in government, and trust in scientific institutions. Analyses of specific government-identified misinformation revealed 3 clusters: prevention (associated with male gender and younger age), causation (associated with lower education level and greater social disadvantage), and cure (associated with younger age). Lower institutional trust and greater rejection of official government accounts were associated with stronger agreement with COVID-19 misinformation. CONCLUSIONS: The findings of this study highlight important gaps in communication effectiveness, which must be addressed to ensure effective COVID-19 prevention.


Subject(s)
Attitude to Health , COVID-19 , Communication , Consumer Health Information , Social Media , Adult , Attitude to Health/ethnology , Australia , COVID-19/psychology , Computer Literacy , Female , Health Literacy , Humans , Longitudinal Studies , Male , Multivariate Analysis , SARS-CoV-2 , Social Media/statistics & numerical data , Socioeconomic Factors , Surveys and Questionnaires , Trust
16.
Dermatol Online J ; 26(11)2020 Nov 15.
Article in English | MEDLINE | ID: covidwho-984130

ABSTRACT

The COVID-19 pandemic required a transition to telemedicine to limit viral spread. Dermatology seems particularly well-suited for telemedicine, however, this pandemic transformed teledermatology into the predominant means of delivering care. Providers are limited in their ability to promptly and accurately manage disease without access to in-person tools. This monumental switch to teledermatology may disadvantage certain patient populations, including those with limited technological literacy (such as the elderly) or access to the internet. Dermatologists must acknowledge these limitations and recognize the consequences of severely limited in-person visits over a prolonged period of time.


Subject(s)
COVID-19 , Dermatology/methods , Skin Diseases/diagnosis , Telemedicine/methods , Biopsy , Computer Literacy , Humans , Internet Access , SARS-CoV-2 , Skin Diseases/pathology , Skin Diseases/therapy
20.
Headache ; 60(8): 1743-1746, 2020 09.
Article in English | MEDLINE | ID: covidwho-607684

ABSTRACT

The COVID-19 health emergency has led many Headache providers to transition to virtual care overnight without preparation. We review our experience and discuss tips to bring humanity to the virtual visits.


Subject(s)
Attitude of Health Personnel , COVID-19/epidemiology , Headache/therapy , Pandemics , Professional-Patient Relations , Telemedicine , Communication Barriers , Computer Literacy , Housing , Humans , Internet , Kinesics , Patient Acceptance of Health Care , Physical Distancing , Privacy , SARS-CoV-2 , Self Care , Telemedicine/instrumentation , Telemedicine/methods , Telephone , Videoconferencing
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