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The removal of regulatory and reimbursement barriers during the COVID-19 pandemic in the United States presented opportunities to explore the potential of telehealth to improve access to and use of healthcare among underserved populations.Therefore, we examined factors associated with accessibility and utilisation of telehealth among older adults during the COVID-19 pandemic. We analysed the nationally representative Medicare Current Beneficiary Survey COVID-19 Supplement File of community-dwelling Medicare beneficiaries aged ≥65 years (n = 5,189), administered from 5 October 2020, through 15 November 2020. Two survey-weighted multivariable logistic regression models were used to assess the association between factors (i.e., socio-demographics, co-morbidities and digital access/literacy) and whether (1) beneficiaries' regular providers offered telehealth during the COVID-19 pandemic, and (2) those being offered telehealth used it. Furthermore, subgroup analyses by residing area and income status were conducted. Of study beneficiaries, 83.6% reported their regular providers offered telehealth during COVID-19. Disparities in accessibility of telehealth by sociodemographic status were observed [e.g., those living in a non-metro area (versus metro) were 7.1% (marginal effect [ME] = −7.1%; p < 0.01) less likely to report accessibility of telehealth]. Beneficiaries who had no access to internet (ME = −8.2%; p < 0.001) and had not participated in video/voice calls/conferencing prior (versus participated) (ME = −6.6%; p < 0.001) were less likely to report having access to telehealth. Among those being offered telehealth services, 43.0% reported using telehealth services. Hispanic and Non-Hispanic Black beneficiaries (e.g., Black versus White; ME = 11.3%; p < 0.01) and those with co-morbidities (versus 0-1 condition) (e.g., 2-3 co-morbidities, ME = 7.3%; p < 0.01) were more likely to report using telehealth services when offered. Similar results were observed in the subgroup analyses regarding disparities in accessibility and utilisation of telehealth. The accessibility and utilisation of telehealth have increased amidst the pandemic; however, disparities in accessibility of telehealth were observed. A telehealth triage protocol is needed to ensure underserved patients continue to receive appropriate care.

The concept of goal setting has been researched and defined throughout different disciplines over the past nine decades. In addition, adjustments to the antecedents, characteristics, and consequences have been made. However, neither a clear concept of goal setting, nor an operational definition is currently available in the literature. TheWalker and Avant Concept Analysis approach was the framework for this paper. Articles and book chapters from 2004 to 2018 were reviewed from Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, and Psych Index.Findings suggest that goal setting is a complex process currently researched in different disciplines. Attributes, antecedents, and consequences of goal setting are discussed along with a suggested operational definition. Model and contrary cases are presented to illustrate the concept. Modifications to the antecedents, characteristics, and consequences of goal setting have emerged from the concept. A result of these changes is better understanding with the ability to produce a more accurate and concise definition. The suggested operational definition of goal setting: goal setting is the action of a person who has the confidence, commitment, motivation, and knowledge necessary to attain a goal that is specific, challenging, measurable, and relevant within a specified amount of time. K E Y W O R D S concept analysis, goal setting, nursing

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