Have cochlear implant, won’t have to travel: introducing telemedicine to people using cochlear implants

Purpose: This paper describes a planned project to design, implement, and evaluate remote care for adults using cochlear implants and compare their outcomes with those following the standard care pathway.Method: Sixty people with cochlear implants will be recruited and randomized to either the remote care group or a control group. The remote care group will use new tools for 6 months: remote and self-monitoring, self-adjustment of device, and a personalized online support tool. The main outcome measure is patient empowerment, with secondary outcomes of hearing and quality of life stability, patient and clinician preference, and use of clinic resources.Conclusion: The clinical trial ends in summer 2016. Remote care may offer a viable method of follow-up for some adults with cochlear implants

Understanding the Intention to Use Telehealth Services in Underserved Hispanic Border Communities: Cross-Sectional Study

Background: Despite the United States having one of the leading health care systems in the world, underserved minority communities face significant access challenges. These communities can benefit from telehealth innovations that promise to improve health care access and, consequently, health outcomes. However, little is known about the attitudes toward telehealth in these communities, an essential first step toward effective adoption and use. Objective: The purpose of this study is to assess the factors that shape behavioral intention to use telehealth services in underserved Hispanic communities along the Texas-Mexico border and examine the role of electronic health (eHealth) literacy in telehealth use intention. Methods: We used cross-sectional design to collect data at a community health event along the Texas-Mexico border. The area is characterized by high poverty rates, low educational attainment, and health care access challenges. Trained bilingual students conducted 322 in-person interviews over a 1-week period. The survey instrument assessed sociodemographic information and telehealth-related variables. Attitudes toward telehealth were measured by asking participants to indicate their level of agreement with 9 statements reflecting different aspects of telehealth use. For eHealth literacy, we used the eHealth Literacy Scale (eHEALS), an 8-item scale designed to measure consumer confidence in finding, evaluating, and acting upon eHealth information. To assess the intention to use telehealth, we asked participants about the likelihood that they would use telehealth services if offered by a health care provider. We analyzed data using univariate, multivariate, and mediation statistical models. Results:Participants were primarily Hispanic (310/319, 97.2%) and female (261/322, 81.1%), with an average age of 43 years. Almost three-quarters (219/298) reported annual household incomes below $20,000. Health-wise, 42.2% (136/322) self-rated their health as fair or poor, and 79.7% (255/320) were uninsured. The overwhelming majority (289/319, 90.6%) had never heard of telehealth. Once we defined the term, participants exhibited positive attitudes toward telehealth, and 78.9% (254/322) reported being somewhat likely or very likely to use telehealth services if offered by a health care provider. Based on multivariate proportional odds regression analysis, a 1-point increase in telehealth attitudes reduced the odds of lower versus higher response in the intention to use telehealth services by 23% (OR 0.77, 95% CI 0.73-0.81). Mediation analysis revealed that telehealth attitudes fully mediated the association between eHealth literacy and intention to use telehealth services. For a 1-point increase in eHEALS, the odds of lower telehealth use decreased by a factor of 0.95 (5%; OR 0.95, 95% CI 0.93-0.98; P Conclusions: Telehealth promises to address many of the access challenges facing ethnic and racial minorities, rural communities, and low-income populations. Findings underscore the importance of raising awareness of telehealth and promoting eHealth literacy as a key step in fostering positive attitudes toward telehealth and furthering interest in its use

Exploring behavioral intention to use telemedicine services post COVID-19: a cross sectional study in Saudi Arabia

IntroductionWhile telemedicine offers significant benefits, there remain substantial knowledge gaps in the literature, particularly regarding its use in Saudi Arabia. This study aims to explore health consumers’ behavioral intention to use telemedicine examining the associated factors such as eHealth literacy and attitudes toward telemedicine services.MethodsA cross-sectional observational study was conducted to collect data on demographics, health status, internet skills, attitudes toward telemedicine, and eHealth literacy. An online survey was administered at two large public gatherings in Riyadh. The eHEALS-Pl scale was used to measure perceived eHealth literacy levels, and data analysis was performed using SPSS (IBM Corp. United States).ResultsThere were 385 participants, with an equal distribution of genders. The largest age group was 18–20 years old (57%). Nearly half of the participants were neither employed nor students, while 43% had access to governmental hospitals through employment. 71% reported proficiency in using the internet. Health-wise, 47% rated their health as excellent, and 56% did not have medical insurance. 87% expressed a high likelihood of using telemedicine if offered by a provider. Participants were categorized based on their eHealth Literacy scores, with 54% scoring low and 46% scoring high. Overall, participants showed positive attitudes toward telemedicine, with 82% agreeing that it saves time, money, and provides access to specialized care. About half of the participants perceived the process of seeing a doctor through telemedicine video as complex. Both eHealth Literacy and attitudes toward telemedicine showed a statistically significant association with the intention to use telemedicine (p < 0.001). There was a positive and significant correlation between eHealth Literacy and attitudes (ρ =0.460; p < 0.001). Multivariate ordinal regression analysis revealed that the odds for a high likelihood of intention to use telemedicine significantly increased with positive attitudes (p < 0.001). Mediation analysis confirmed the significant mediating role of attitudes toward telemedicine in the relationship between eHealth Literacy and the intention to use telemedicine.ConclusionThe findings underline the importance of enhancing health literacy and consumer attitudes toward telemedicine, particularly during the healthcare digital transformation we are experiencing globally. This is crucial for promoting increased acceptance and utilization of telemedicine services beyond the COVID-19 pandemic

Impact of Healthcare Providers’ Perception on Telehealth Implementation

Telehealth has been proven to have a significant impact on patient outcomes; however, the use of telehealth in both rural and urban areas is sporadic and inconsistent. Although researchers have investigated this issue, there is little literature on the understanding of the impact healthcare provider (HCP) perception plays in this sporadic usage. The purpose of this quantitative research study was to understand how perception and behavioral intention of HCPs impacted the use of telehealth in rural and urban areas. The unified theory of acceptance and technology (UTAUT) was used to structure this research to facilitate determining the correlation between perception and behavioral intention to use telehealth. This theory was used to determine how each of the theory constructs (performance expectancy, effort expectancy, social influence, and facilitating conditions) impacted HCPs’ behavioral intention to use telehealth. Data were collected through a questionnaire developed from the UTAUT model that was sent to HCPs in California with a total of 45 responses. The study revealed a correlation between performance expectancy and behavioral intention (F (6,38) = 6.526, P \u3c .001, R2 = .507), indicating that a higher performance expectancy was positively related to behavioral intention. Results of both the ANOVA and independent samples t test indicated that neither provider type nor location correlated with behavioral intention. Findings may result in positive social change through the increase of telehealth use through addressing HCPs concerns with performance expectations and thus increase the health of communities lacking lack access to care

A Multilevel Mixed Methods Examination of Treatment Nonadherence Among Rural Cancer Survivors

While mortality rates have been decreasing over the last 40 years, cancer remains a leading cause of death in the United States. Over 1.7 million people were diagnosed with cancer in 2019, and there were more than 600,000 cancer deaths. Of the 15 million cancer survivors in the US, nearly 3 million reside in rural areas and experience 3% higher cancer incidence and 10% higher cancer mortality compared to their nonrural counterparts. During 2006-2015, the annual age-adjusted mortality rates for all cancer sites combined decreased at a slower pace in rural areas versus nonrural areas (-1.0% vs -1.6% per year, respectively), widening the disparity in mortality rates. Although the reasons for these disparities are not fully known, rural cancer survivors tend to be older, have additional comorbidities and poorer general health, and have a higher prevalence of lifestyle risk factors, such as smoking and lack of physical activity, that complicate survival and may contribute to the higher mortality rate. Nonadherence to cancer treatment is associated with poorer cancer outcomes, including higher rates of cancer recurrence or treatment failure and decreased survival. Reports of mortality have been up to four times as likely in nonadherent compared with adherent survivors. A growing set of studies have begun to document that cancer treatment adherence is poorer among rural populations, which may also partially explain the higher mortality rate observed in rural areas. This dissertation is comprised of three studies: 1) a systematic review of the role of digital health in rural oncology; 2) a data analysis of hospital and billing claims data examining geographic differences in sociodemographic and clinical factors associated with radiation treatment nonadherence; and 3) a multilevel, theory-driven examination of rural cancer treatment nonadherence utilizing survey and individual interview data

Identifying The Readiness Of Patients In Implementing Telemedicine In Northern Louisiana For An Oncology Practice

This study identified the readiness factors that may create challenges in the use of telemedicine among patients in northern Louisiana with cancer. To identify these readiness factors, the team of investigators developed 19 survey questions that were provided to the patients or to their caregivers. The team collected responses from 147 respondents from rural and urban residential backgrounds. These responses were used to identify the individuals\u27 readiness for utilising telemedicine through factor analysis, Cronbach\u27s alpha reliability test, analysis of variance and ordinary least squares regression. The analysis results indicated that the favourable factor (positive readiness item) had a mean value of 3.47, whereas the unfavourable factor (negative readiness item) had a mean value of 2.76. Cronbach\u27s alpha reliability test provided an alpha value of 0.79. Overall, our study indicated a positive attitude towards the use of telemedicine in northern Louisiana