Families prefer in-person visits to telehealth for pediatric weight management during the pandemic

ABSTRACT

Background: The COVID-19 pandemic has presented multiple challenges to families participating in pediatric weight management programs (PWMP) and to medical providers in accessing and offering care. To accommodate patient/family needs our PWMP turned to telehealth exclusively early in the COVID-19 Pandemic. After in-person clinic visits were reestablished, telehealth was offered as an alternative option. The purpose of this study was to compare whether families chose in-person or telehealth visits when both options were available during the pandemic. Methods: A retrospective review of patient visits was analyzed from July 1, 2020, through December 31, 2020, of all visits to our PWMP. During this period, families were given the option of scheduling in-person clinic visits in our PWMP or being seen by telehealth for both new and follow- up visits. Families could be seen by a doctor, dietitian, and exercise physiologist at both types of visits. Descriptive statistics, frequencies, and percentages, for patient demographics and visit type, were determined, and associations were analyzed using logistic regression. Results: There were 1356 completed PWMP visits, with 977 (72.1%) done in-person and 379 (27.9%) by Telehealth. Patients had a mean age of 12.5 years, were 51.2% female, 51.9% White, 28.8% Black, 10.2% Hispanic, and 64.5% had Medicaid. The age of telehealth patients was greater (12.9 years versus 12.3 years, P = 0.041), and the percentage of follow-up visits was greater (81.5% versus 65.5%, P < 0.0001). There was no significant difference in race/ethnicity or insurance type. Telehealth was selected more often for follow-up visits compared to new visits [odds ratio (OR) = 2.052, P = 0.008]. Compared to White patients, Black patients selected Telehealth more often (OR = 1.371;P = 0.03) whereas Hispanic patients did not (OR = 0.819;P = 0.412). Conclusions: A solid majority of families choose in-person visits over telehealth when given the opportunity during the COVID-19 Pandemic. Factors favoring telehealth were being Black and having a follow-up visit. While telehealth increases flexibility and increases options to families, in-person clinic visits seem to be preferred especially for an initial visit.