Telemedicine Use in Refugee Primary Care: Implications for Care Beyond the COVID-19 Pandemic

Blackstone, Sarah; Hauck, Fern R.

doi:10.1007/s10903-022-01360-6

Cited by 10 publications

(12 citation statements)

References 46 publications

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“…Despite substantial investment and an increasing number of DHTs available to health care consumers, their uptake has been limited among some population groups [8]. These include lower-socioeconomic-level groups and people from culturally and linguistically diverse (CaLD) communities, with the latter including racial or ethnic minority groups, immigrants and refugees, and First Nations people [8][9][10][11][12][13][14][15]. Studies have repeatedly reported that CaLD populations have lower uptake and use of DHTs than non-CaLD populations [8,16,17].…”

Section: Introductionmentioning

confidence: 99%

Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review

Whitehead¹,

Talevski²,

Fatehi³

et al. 2023

J Med Internet Res

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Background Health care systems have become increasingly more reliant on patients’ ability to navigate the digital world. However, little research has been conducted on why some communities are less able or less likely to successfully engage with digital health technologies (DHTs), particularly among culturally and linguistically diverse (CaLD) populations. Objective This systematic review aimed to determine the barriers to and facilitators of interacting with DHTs from the perspectives of CaLD population groups, including racial or ethnic minority groups, immigrants and refugees, and Indigenous or First Nations people. Methods A systematic review and thematic synthesis of qualitative studies was conducted. Peer-reviewed literature published between January 2011 and June 2022 was searched across 3 electronic databases. Terms for digital health were combined with terms for cultural or linguistic diversity, ethnic minority groups, or Indigenous and First Nations people and terms related to barriers to accessing digital technologies. A qualitative thematic synthesis was conducted to identify descriptive and analytical themes of barriers to and facilitators of interacting with DHTs. Quality appraisal was performed using the Mixed Methods Appraisal Tool. Results Of the 1418 studies identified in the electronic search, a total of 34 (2.4%) were included in this review. Half of the included studies (17/34, 50%) were conducted in the United States. There was considerable variation in terms of the CaLD backgrounds of the participants. In total, 26% (9/34) of the studies focused on Indigenous or First Nations communities, 41% (14/34) were conducted among ethnic minority populations, 15% (5/34) of the studies were conducted among immigrants, and 18% (6/34) were conducted in refugee communities. Of the 34 studies, 21 (62%) described the development or evaluation of a digital health intervention, whereas 13 (38%) studies did not include an intervention but instead focused on elucidating participants’ views and behaviors in relation to digital health. From the 34 studies analyzed, 18 descriptive themes were identified, each describing barriers to and facilitators of interacting with DHTs, which were grouped into 7 overarching analytical themes: using technology, design components, language, culture, health and medical, trustworthiness, and interaction with others. Conclusions This study identified several analytic and descriptive themes influencing access to and uptake of DHTs among CaLD populations, including Indigenous and First Nations groups. We found that cultural factors affected all identified themes to some degree and that cultural and linguistic perspectives should be considered in the design and delivery of DHTs, with this best served through the inclusion of the target communities at all stages of development. This may improve the potential of DHTs to be more acceptable, appropriate, and accessible to population groups currently at risk of not obtaining the full benefits of digital health.

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Section: Introductionmentioning

confidence: 99%

Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review

Whitehead¹,

Talevski²,

Fatehi³

et al. 2023

J Med Internet Res

View full text Add to dashboard Cite

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“…However, since the migrant population has usually less stable employment conditions compared to the native population and migrants are overrepresented in a number of sectors such as the hospitality industry [ 23 ], it is very likely that immigrant women encountered more challenges to access telehealth services during the pandemic, such as the online version of prenatal courses. Similar groups, such as US refugees, showed having less access to telemedicine than non-refugees during the COVID-19 pandemic, mainly due to language barriers and other logistic issues [ 24 ]. Finally, women enrolled in Naples, with lower levels of education, housewives or unemployed as well as multiparous women were less likely to attend the prenatal course.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Prenatal Care Utilization Among Italian and Immigrant Pregnant Women: A Multicenter Survey

Vilca,

Sarno,

Passoni

et al. 2024

Int J Public Health

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Objectives: To compare the utilization of prenatal services between immigrant and Italian women during the COVID-19 pandemic.Methods: A cross-sectional survey was conducted at 3 maternity care centers in Italy.Results: We included 1,312 women, 1,198 (91.3%) were Italian and 114 (8.7%) were immigrants. A significantly higher proportion of Italians underwent 8 or more prenatal care visits (64.4% vs. 54.4%, p = 0.03) and more immigrants than Italians attended their appointments at hospital settings (45% vs. 18%, p < 0.001). Regarding prenatal course, Italians were more likely than immigrants to attend a non-hospital setting or an online class (49.6% and 30.2% vs. 34.9% and 11.6%, p = 0.008). A higher influenza vaccine uptake among immigrants compared with Italians was observed (39.5% vs. 19.8%, p < 0.001). Among women not receiving certain prenatal services, immigrants were more likely to state COVID-19 pandemic was the main reason for non-compliance.Conclusion: Immigrant pregnant women were more likely to receive prenatal services at a hospital setting than their Italian counterparts. Among women who did not comply with prenatal services, immigrants were more likely to cite the pandemic as their main reason.

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“…In particular, providers worried that patients who did not speak English, had disabilities impacting their ability to use technology, or were from lower socioeconomic backgrounds faced more barriers with virtual visits. Previous studies have also found that telemedicine has worsened health care disparities due to difficulty accessing care (eg, people of color, non-English speakers, individuals with substance use disorders [31][32][33] ). In particular, satisfaction with and use of virtual visits has been mixed among older adults.…”

Section: Discussionmentioning

confidence: 99%

Perceived Impact of Virtual Visits on Access to Care in Family Medicine During the COVID-19 Pandemic: A Qualitative Study of Benefits and Challenges

Ho,

Fortenberry,

Gardner

et al. 2023

J Prim Care Community Health

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Background: The COVID-19 pandemic in 2020 led to the rapid adoption of telemedicine, including virtual visits, to minimize face-to-face contact between clinicians and patients. Family medicine clinics across the nation had to transform how they provided primary care while maintaining the core values of family medicine. The objective of this study was to analyze how family medicine faculty perceived the impact of virtual visits on patient access to care. Methods: This qualitative study took place in an academic primary care setting. We interviewed clinical faculty who utilized virtual visits about their experiences from June to December 2020. We used qualitative content analysis to evaluate the results of the interviews. Results: The study included a total of 20 participants. The mean age was 43.4 years, and 85% of participants were female. Researchers developed 3 themes, “Logistics of virtual visits,” “reigniting the concept of home visits,” and “barriers and benefits that affect specific patient populations” that describe how virtual visits have impacted patients’ access to care. The results highlight how virtual visits improve access to care by increasing flexibility for patients and providers and provide a new perspective into a patient’s home life. Challenges of virtual visits include language barriers, technological issues, and issues unique to vulnerable patient populations. Conclusion: Virtual visits can enhance family medicine’s ability to provide accessible care, but there are concerns it may worsen health disparities. Further research and quality improvement projects are needed to examine ways to implement innovative care delivery solutions to avoid further exacerbating these disparities.

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Telemedicine Use in Refugee Primary Care: Implications for Care Beyond the COVID-19 Pandemic

Cited by 10 publications

References 46 publications

Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review

Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review

Impact of the COVID-19 Pandemic on Prenatal Care Utilization Among Italian and Immigrant Pregnant Women: A Multicenter Survey

Perceived Impact of Virtual Visits on Access to Care in Family Medicine During the COVID-19 Pandemic: A Qualitative Study of Benefits and Challenges

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