Towards Understanding Disparities in Using Technology to Access Health Care Information: African American Veterans’ Sociocultural Perspectives on Using My Health<i>e</i>Vet for Diabetes Management

Johnson, Nathan C.

doi:10.1080/10410236.2022.2071392

Cited by 5 publications

(7 citation statements)

References 29 publications

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“…A significantly higher proportion of non‐Whites were not aware that they could access health records electronically, were registered to use EMR, or even if registered, never used the EMR. A prior, smaller study in the VA system has shown some sociocultural issues related with lower EMR utilization by African‐Americans 25 . In our study, it was very encouraging to see that a higher proportion of non‐Whites were interested in learning about the EMR as compared to whites, although this may be due to a larger existing knowledge gap among the non‐White cohort.…”

Section: Discussionsupporting

confidence: 55%

“…A prior, smaller study in the VA system has shown some sociocultural issues related with lower EMR utilization by African‐Americans. 25 In our study, it was very encouraging to see that a higher proportion of non‐Whites were interested in learning about the EMR as compared to whites, although this may be due to a larger existing knowledge gap among the non‐White cohort. We had set up our survey on the hypothesis that EMR utilization by non‐whites would be lesser and so, we explored what could increase EMR utilization by those who were not yet on board with it.…”

Section: Discussionmentioning

confidence: 59%

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The digital divide: Racial disparities in adoption and utilization of health information technology among patients with lymphoid cancers

Ailawadhi,

Dutta

et al. 2023

Cancer Medicine

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IntroductionHealth information technology (HIT) has the potential to improve healthcare delivery and engagement. Studying racial‐ethnic disparities in HIT engagement will help understand and overcome challenges to healthcare utilization.MethodsWe undertook a patient‐reported survey among patients with lymphoid malignancies at two campuses of Mayo Clinic, Florida to explore HIT‐related disparities. Variables between Whites and non‐Whites, and non‐Whites from the two campuses were compared.ResultsThe survey was completed by 1004 respondents, with 71% whites, 27% non‐Whites (race‐ethnicity not reported by 2%). Non‐Whites included 30% responders at the main campus and 64% at an inner‐city campus. Whites were significantly older and had higher education, while non‐Whites had lesser access to a computer. Only 51% of non‐Whites were registered to use electronic medical records (EMR) as compared to 72% Whites (p < 0.001) and significantly lesser number of non‐Whites even knew that EMR existed (81% vs. 92%, p < 0.001). Encouragingly, a higher number of non‐Whites wanted to engage in EMR. Non‐Whites from the main campus were older, more educated and had more access to a computer as compared to those from the inner‐city campus. Similar disparate factors were noted among minorities from the two campuses, suggesting impact of socioeconomic backgrounds on EMR usage among non‐Whites. Linguistic barriers were more striking among inner‐city campus non‐Whites.ConclusionsNon‐Whites continue to struggle with suboptimal utilization of the healthcare system and barriers related to integration in HIT, including disparities representing socioeconomic differences. Efforts need to be made at several levels to help racial‐ethnic minorities overcome awareness, access, and linguistic barriers to HIT utilization.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 59%

The digital divide: Racial disparities in adoption and utilization of health information technology among patients with lymphoid cancers

Ailawadhi,

Dutta

et al. 2023

Cancer Medicine

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“…One point of concern is the potential for video care to increase disparities in health care access among racial and ethnic groups who may have health care access barriers prior to the pandemic [8][9][10]25]. In our evaluation, we found no statistically significant differences in video use among all racial and ethnic groups during the pandemic.…”

Section: Principal Findingsmentioning

confidence: 51%

“…The goal of this intensive tablet distribution effort was to facilitate video care and thereby reduce risks of COVID-19 exposure for patients and providers, preserve facility resources for higher-acuity patients, and support continuity of care for patients who might otherwise be unable to access care [4][5][6][7]. However, it was unclear how this rapid transition to video care would influence individuals with complex medical and social needs [8], including individuals who often experience "digital divide" disparities in accessing video care, including older adults, certain racial minority groups, and individuals who have low-income or reside in rural locations [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Overcoming Access Barriers for Veterans: Cohort Study of the Distribution and Use of Veterans Affairs’ Video-Enabled Tablets Before and During the COVID-19 Pandemic

Dhanani¹,

Ferguson²,

Campen³

et al. 2023

J Med Internet Res

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Background During the COVID-19 pandemic, as health care services shifted to video- and phone-based modalities for patient and provider safety, the Veterans Affairs (VA) Office of Connected Care widely expanded its video-enabled tablet program to bridge digital divides for veterans with limited video care access. Objective This study aimed to characterize veterans who received and used US Department of VA–issued video-enabled tablets before versus during the COVID-19 pandemic. Methods We compared sociodemographic and clinical characteristics of veterans who received VA-issued tablets during 6-month prepandemic and pandemic periods (ie, from March 11, 2019, to September 10, 2019, and from March 11, 2020, to September 10, 2020). Then, we examined characteristics associated with video visit use for primary and mental health care within 6 months after tablet shipment, stratifying models by timing of tablet receipt. Results There was a nearly 6-fold increase in the number of veterans who received tablets in the pandemic versus prepandemic study periods (n=36,107 vs n=6784, respectively). Compared to the prepandemic period, tablet recipients during the pandemic were more likely to be older (mean age 64 vs 59 years), urban-dwelling (24,504/36,107, 67.9% vs 3766/6784, 55.5%), and have a history of housing instability (8633/36,107, 23.9% vs 1022/6784, 15.1%). Pandemic recipients were more likely to use video care (21,090/36,107, 58.4% vs 2995/6784, 44.2%) and did so more frequently (5.6 vs 2.3 average encounters) within 6 months of tablet receipt. In adjusted models, pandemic and prepandemic video care users were significantly more likely to be younger, stably housed, and have a mental health condition than nonusers. Conclusions Although the COVID-19 pandemic led to increased distribution of VA-issued tablets to veterans with complex clinical and social needs, tablet recipients who were older or unstably housed remained less likely to have a video visit. The VA’s tablet distribution program expanded access to video-enabled devices, but interventions are needed to bridge disparities in video visit use among device recipients.

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“…African Americans are less likely than other groups to trust and use digital approaches (Best et al, 2021;Johnson, 2022;Gergen Barnett et al, 2022). Current theoretical frameworks to study the effects of SDH on health outcomes need to be modified with technical adoption approaches to understanding SDH's impact on DHI.…”

Section: List Of Tables and Figuresmentioning

confidence: 99%

Policy barriers to the adoption of digital health interventions in the management of chronic type 2 diabetes among African-American adults in the United States

Sagar

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Towards Understanding Disparities in Using Technology to Access Health Care Information: African American Veterans’ Sociocultural Perspectives on Using My HealtheVet for Diabetes Management

Cited by 5 publications

References 29 publications

The digital divide: Racial disparities in adoption and utilization of health information technology among patients with lymphoid cancers

The digital divide: Racial disparities in adoption and utilization of health information technology among patients with lymphoid cancers

Overcoming Access Barriers for Veterans: Cohort Study of the Distribution and Use of Veterans Affairs’ Video-Enabled Tablets Before and During the COVID-19 Pandemic

Policy barriers to the adoption of digital health interventions in the management of chronic type 2 diabetes among African-American adults in the United States

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