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. 2023 Feb 2;20(3):2675.
doi: 10.3390/ijerph20032675.

Factors Associated with Telehealth Utilization among Older African Americans in South Los Angeles during the COVID-19 Pandemic

Tavonia Ekwegh  1 , Sharon Cobb  1 , Edward K Adinkrah  2 , Roberto Vargas  3 , Lucy W Kibe  4 , Humberto Sanchez  5 , Joe Waller  5 , Hoorolnesa Ameli  6 , Mohsen Bazargan  2   7
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Factors Associated with Telehealth Utilization among Older African Americans in South Los Angeles during the COVID-19 Pandemic

Tavonia Ekwegh et al. Int J Environ Res Public Health. .

Abstract

Background: The COVID-19 pandemic transformed healthcare delivery with the expansive use of telemedicine. However, health disparities may result from lower adoption of telehealth among African Americans. This study examined how under-resourced, older African Americans with chronic illnesses use telehealth, including related sociodemographic and COVID-19 factors.

Methods: Using a cross-sectional design, 150 middle-aged and older African Americans were recruited from faith-based centers from March 2021 to August 2022. Data collected included sociodemographics, comorbidities, technological device ownership, internet usage, and attitudes toward COVID-19 disease and vaccination. Descriptive statistics and multivariable regression models were conducted to identify factors associated with telehealth use.

Results: Of the 150 participants, 32% had not used telehealth since the COVID-19 pandemic, with 75% reporting no home internet access and 38% having no cellular/internet network on their mobile device. Age, access to a cellular network on a mobile device, and wireless internet at home were significantly associated with the utilization of telehealth care. Higher anxiety and stress with an increased perceived threat of COVID-19 and positive attitudes toward COVID-19 vaccination were associated with telehealth utilization.

Discussion: Access and integration of telehealth services were highlighted as challenges for this population of African Americans. To reduce disparities, expansion of subsidized wireless internet access in marginalized communities is necessitated. Education outreach and training by healthcare systems and community health workers to improve uptake of telehealth currently and post-COVID-19 should be considered.

Keywords: African Americans; COVID-19; access to cellular network and Wi-Fi; ethnic groups; older adults; telehealth service utilization.

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Conflict of interest statement

All authors certify that they have no affiliation with or involvement in any organization or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript. There are no conflict and financial interest to declare. No connections, direct or indirect, or other situations that might raise the question of bias in work were reported for any of the authors or for the associated departments or CDU.

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