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Srinivasan Y, Andreadis K, Ballakur SS, Rameau A. Access to Otolaryngologic Telemedicine Care Across the COVID-19 Pandemic at an Urban Tertiary Hospital System. EAR, NOSE & THROAT JOURNAL 2024; 103:76S-84S. [PMID: 38488168 DOI: 10.1177/01455613241240560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
Objective: To describe associations between patients' demographic characteristics and access to telemedicine services in an urban tertiary academic medical system across the COVID-19 pandemic, and to identify potential barriers to access. Methods: This was a retrospective cohort study conducted at a single-center tertiary academic medical center. The study included adult patients undergoing outpatient otolaryngologic care in person or via telemedicine during 8 week timeframes: before the pandemic, at the onset of the pandemic, and during later parts of the pandemic. Patients were characterized by age, sex, race, insurance type, primary language, portal activation status, income estimate, and visit type. Where appropriate, chi-squared tests, Wilcoxon signed-rank tests, and logistic regression were used to compare demographic factors between the cohorts. Results: A total of 14,240 unique patients [median age, 58 years (range, 18-107 years); 56.5% were female] resulting in a total of 29,457 visits (94.8% in-person and 5.2% telemedicine) were analyzed. Patients seen in person were older than those using telemedicine. Telemedicine visits included a higher proportion of patients with private insurance, and fewer patients with government or no insurance compared to in-person visits. Race, income, and English as primary language were not found to have a significant effect on telemedicine use. Conclusion: In an urban tertiary medical center, we found significant differences in sociodemographic characteristics between patients who accessed otolaryngologic care in person versus via telemedicine through different phases of the COVID pandemic, reflecting possible barriers to care associated with telemedicine. Further studies are needed to develop interventions to improve access.
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Affiliation(s)
- Yashes Srinivasan
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Katerina Andreadis
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Sarita S Ballakur
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Anaïs Rameau
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
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Ruggiero C, Macchione IG, Gemo V, Properzi C, Perini F, Bianco A, Ercolani MC, Mencacci M, Manzi P, Pasqualucci A, De Filippis G, Baroni M, Mecocci P. Effectiveness and Satisfaction with Telemedicine in Geriatric Patients at High Risk of Fragility Fractures. Telemed J E Health 2024; 30:e2040-e2049. [PMID: 38656125 DOI: 10.1089/tmj.2023.0708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Background: Telemedicine has increasingly widespread to improve the monitoring of patients with chronic diseases. Secondary prevention of fragility fractures is an urgent matter to be addressed by means of available technology, although supported by little evidence so far. We investigated the feasibility, efficacy, and satisfaction of managing older adults at high risk of fragility fractures during the COVID-19 lockdown. Methods: During the period January to July 2021, a prospective observational study for safety and adherence purposes was conducted among older adults (n = 407) with ongoing treatments for secondary prevention of fragility fractures. The study procedures comply with national and regional resolutions related to telemedicine service (TS), including equipment, staff behaviors, and patient reports. Results: A majority (86.48% [n = 352]) of the eligible patients joined the remote visits, mainly women (88.2%), 81.4 ± 8.8 years of age, 49.6% independent in 5 out of 6 BADL, despite high comorbidity (4.9 ± 1.5), and polypharmacy (4.9 ± 3.1). Almost all were on second-line antifracture treatments (95.58%) due to previous major (84.03%) and minor (42.5%) fragility fractures. About 58% reported good and very good reliability of the internet network, allowing easy access to the TS platform, and 54% declared the degree of satisfaction with TS as good and very good. About 75% of clinicians acknowledged the efficacy of TS and expressed willingness to recommend the use of TS to colleagues. Ultimately, 68% of specialists defined the time allocated for patients' remote visits as acceptable. Conclusion: TS may be an opportunity to improve the availability of appropriate health care services to satisfy patients' needs and optimize health care resource allocation.
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Affiliation(s)
- Carmelinda Ruggiero
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Ilaria Giovanna Macchione
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Valentina Gemo
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Chiara Properzi
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Federica Perini
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Annarita Bianco
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Maria Cristina Ercolani
- IT Systems and Transition to Digital Administration, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Marco Mencacci
- Technological Infrastructure Development, IT Department, Municipality of Florence, Firenze, Italy
| | - Pietro Manzi
- Medical Direction, S. Maria Hospital, Terni, Italy
| | | | | | - Marta Baroni
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
| | - Patrizia Mecocci
- Orthogeriatric Service, Geriatric Unit, Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, S. Maria Della Misericordia Hospital, Perugia, Italy
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Abuyadek RM, Hammouda EA, Elrewany E, Elmalawany DH, Ashmawy R, Zeina S, Gebreal A, Ghazy RM. Acceptability of Tele-mental Health Services Among Users: A Systematic Review and Meta-analysis. BMC Public Health 2024; 24:1143. [PMID: 38658881 PMCID: PMC11040906 DOI: 10.1186/s12889-024-18436-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Mental disorders are currently a global public health concern, particularly after the coronavirus disease 2019 (COVID-19) pandemic. Mental health services gradually transitioned to teleservices, employing various methods like texting and videoconferencing. This meta-analysis aimed mainly to quantify the acceptability of tele-mental health services among both beneficiaries and providers. Secondary objectives included quantifying the usability of and satisfaction with these services. METHODS We conducted a systematic search of the following databases PubMed Central, SAGE, Google Scholar, Scopus, Web of Science, PubMed Medline, and EBSCO according to Preferred Reporting Items of the Systematic Reviews and Meta-Analysis (PRISMA) guidelines until December 2022. RESULTS Out of 3366 search results, 39 studies fully met the inclusion criteria. The pooled acceptability of tele-mental health services among beneficiaries was [71.0% with a 95% confidence interval (CI) of 63.0 - 78.5%, I2 = 98%]. Using meta-regression, four key factors contributed to this heterogeneity (R2 = 99.75%), namely, year of publication, type of mental disorder, participant category, and the quality of included studies. While acceptability among providers was [66.0% (95%CI, 52.0 - 78.0%), I2 = 95%]. The pooled usability of tele-mental health services among participants was [66.0% (95%CI, 50.0 - 80.0%), I2 = 83%]. Subgroup analysis revealed statistically significant results (p = 0.003), indicating that usability was higher among beneficiaries compared to providers. CONCLUSIONS The study highlighted a high acceptability of tele-mental health services. These findings suggest a promising outlook for the integration and adoption of tele-mental health services and emphasize the importance of considering user perspectives and addressing provider-specific challenges to enhance overall service delivery and effectiveness.
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Affiliation(s)
- Rowan M Abuyadek
- Health Administration and Behavioral Sciences Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Esraa Abdellatif Hammouda
- Clinical Research Department, El-Raml Pediatric Hospital, Ministry of Health and Population, Alexandria, Egypt
| | - Ehab Elrewany
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
| | | | - Rasha Ashmawy
- Department of Clinical Research, Maamora Chest Hospital, MoHP, Alexandria, Egypt
- Clinical Research Administration, Directorate of Health Affairs, MoHP, Alexandria, Egypt
| | - Sally Zeina
- Department of Clinical Research, Maamora Chest Hospital, MoHP, Alexandria, Egypt
| | - Assem Gebreal
- Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
- Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Ejezie CL, Choi J, Ayieko S, Burgoa S, Zerrouki Y, Lobaina D, Okwaraji G, Defeu S, Sacca L. Digital Health Interventions for Cancer Prevention Among Racial and Ethnic Minority Groups in the United States: A Scoping Review. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01958-6. [PMID: 38587751 DOI: 10.1007/s40615-024-01958-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE The COVID-19 pandemic abruptly accelerated the use of digital health for cancer care. Previously, researchers identified a variety of digital health interventions for cancer prevention. The purpose of the present scoping review was to identify digital health interventions for cancer prevention designed for racial/ethnic minority groups. METHODS The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and was guided by the Arksey and O'Malley methodological framework. A search of PubMed, Ovid MEDLINE, and CINAHL for peer-reviewed research articles published from database inception to August 21, 2023, was conducted. Peer-reviewed studies published in English that employed digital health interventions for cancer prevention, that were conducted among racial/ethnic minority groups, and that were conducted in the United States were included. Also included were cancer prevention interventions for people who did not have cancer, people who did have cancer, and cancer survivors. Excluded were interventions that included non-Hispanic White individuals, interventions performed outside the United States, interventions that combined face-to-face methods with digital strategies, and interventions that did not clearly include digital health. Articles that focused on technologies for collecting and transmitting health data (e.g., remote patient monitoring) without an explicit tie-in to cancer prevention intervention outcomes were also excluded. RESULTS Following screening, eight articles met the eligibility criteria. Six of the articles were published prior to the COVID-19 pandemic, and two were published during it. The digital health interventions for cancer prevention in racial/ethnic minority groups included screening (n = 5), emotional support and education (n = 1), human papillomavirus vaccination (n = 1), and education and treatment (n = 1). A consistently measured outcome was intervention efficacy. Four authors explicitly stated that theories or theoretical constructs were employed to guide intervention development. Also, no interventions were created using novel devices such as emerging technologies. CONCLUSIONS We identified several notable gaps regarding digital health for cancer prevention among racial/ethnic minority groups. Addressing these gaps may help guide continued innovation in the use of digital health for cancer prevention among racial/ethnic minority groups.
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Affiliation(s)
- Chinenye Lynette Ejezie
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
| | - Jihye Choi
- UTHealth Houston School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Sylvia Ayieko
- UTHealth Houston School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Sara Burgoa
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Yasmine Zerrouki
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Diana Lobaina
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Goodness Okwaraji
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Sandrine Defeu
- Tulane University School of Medicine, 1430 Tulane Avenue, New Orleans, LA, 70112, USA
| | - Lea Sacca
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA
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Gallardo MO, Dela Torre J, Ebardo R. The Role of Initial Trust in the Behavioral Intention to Use Telemedicine Among Filipino Older Adults. Gerontol Geriatr Med 2024; 10:23337214231222110. [PMID: 38196939 PMCID: PMC10775724 DOI: 10.1177/23337214231222110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/11/2024] Open
Abstract
This study investigated the behavioral intention of Filipino older adults toward using telemedicine and the pivotal role of initial trust in influencing this intention. A cross-sectional method was employed, involving a questionnaire administered to 180 participants using convenience sampling. The structural model test results indicate that subjective norm, attitude, and notably, initial trust positively impact the behavioral intention to use telemedicine, whereas perceived behavioral control does not significantly affect intention. This underscores the significance of subjective norm and attitude in shaping behavioral intention, consistent with the Theory of Planned Behavior (TPB), while the extended construct of initial trust played a crucial role in influencing the attitude and intention of older adults, highlighting its importance in technology adoption. The study aligns with the trend of increased telemedicine adoption during the COVID-19 pandemic, emphasizing the need for trust in sensitive healthcare contexts. Establishing initial trust is vital for successful telemedicine implementation among Filipino older adults, enhancing healthcare accessibility and well-being.
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Affiliation(s)
- Maureen Olive Gallardo
- De La Salle University, Manila, Philippines
- Ateneo de Zamboanga University, Zamboanga City, Philippines
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Fitch K, Bohn JA, Emerson JB, Boniface ER, Bruegl A. Acceptability of human papillomavirus self-collection and the role of telehealth: a prospective, randomized study stratified by menopausal status. Int J Gynecol Cancer 2023:ijgc-2023-004935. [PMID: 38101813 DOI: 10.1136/ijgc-2023-004935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE We investigated the utility of telehealth instruction versus mail-based written instruction in facilitating high-risk human papillomavirus (hrHPV) self-collection among post-menopausal patients compared with pre-menopausal patients, as well as the impact on acceptability and feasibility. METHODS We conducted a prospective, randomized study of people eligible for cervical cancer screening, stratified by menopausal status, to undergo standard written or telehealth-based instructions for hrHPV self-collection. English speaking individuals residing in Oregon, with a cervix, eligible for primary hrHPV testing, and with access to a video-capable device were included. Patients with prior hysterectomy, trachelectomy, diagnosis of cervical cancer, or pelvic radiation for gynecologic cancer were excluded. We compared preference for and opinions about self-collection and hrHPV test results, by randomization group and stratified by menopausal status using descriptive statistics. RESULTS Among 123 patients enrolled, 61 identified as post-menopausal with a median age of 57 years. While the majority of post-menopausal participants who received telehealth instructions found it helpful, only 6.1% considered telehealth instructions necessary to complete self-testing. There was no difference in opinion of telehealth by menopausal status. Overall, 88.5% of post-menopausal participants preferred self-collection to provider-collection. There were no significant differences between pre- and post-menopausal participants in terms of test preference, discomfort, ease of use, or perceptions of self-collection. CONCLUSION Telehealth instruction did not add significant value to patients participating in hrHPV self-collection, nor did it alter the acceptability of hrHPV-self collection among an English-speaking cohort. Compared with prior experiences with provider-collected screening, hrHPV self-collection was preferred by both pre- and post-menopausal participants. There were no significant differences in preference for provider- versus self-collection when stratified by menopausal status.
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Affiliation(s)
- Katherine Fitch
- Department of Obstetrics & Gynecology, OHSU, Portland, Oregon, USA
| | - Jacqueline A Bohn
- Department of Obstetrics & Gynecology, University of Oklahoma, Norman, Oklahoma, USA
| | - Jenna B Emerson
- Department of Obstetrics & Gynecology, OHSU, Portland, Oregon, USA
| | - Emily R Boniface
- Department of Obstetrics & Gynecology, OHSU, Portland, Oregon, USA
| | - Amanda Bruegl
- Department of Obstetrics & Gynecology, OHSU, Portland, Oregon, USA
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