Telehealth and Transportation Among African Americans with HIV During the COVID-19 Pandemic Open Access
Roberts, Samuel (Summer 2024)
Abstract
Introduction: “Telehealth” and “telemedicine” refer to interactions between patients and medical staff or physicians, with the latter referring specifically to clinical interactions and interventions. While helpful in many ways for patients and providers, telehealth presents its own set of issues. For many African Americans with HIV (AAWH) before the pandemic, access to transportation was already an issue, but not all clinical interactions can take place remotely. This document identifies telehealth and transportation barriers specific to this population.
Methods: This study employs a mixed-methods analysis of quantitative survey data (N=200) and in-depth interview transcripts (N=10) collected from a cohort of AAWH from any of three participating hospitals in Atlanta, GA in 2021. Quantitative analysis included cross-tabulation of predictor demographic/clinical variables with transportation-related outcome variables. Qualitative analysis took a thematic approach centered around the main themes of telehealth and transportation.
Results: We produced descriptive statistics for the overall study population and chi-square statistics for all of our cross-tabulations. The only statistically significant result we found was that persons with comorbidities that are not well controlled are at a higher risk of missing a dose of HIV medication in the past 30 days. Thematic analysis characterized our population’s experiences and attitudes of telehealth and transportation.
Discussion: Our results allow for some comparison with the literature. Our population appeared to have lower likelihood of missing an appointment than the national average during the COVID-19 pandemic. Latino/Hispanic individuals in our study also experienced fewer missed appointments than the literature suggests.
Limitations: The original study whose survey and interview data we used was not meant to focus on telehealth and transportation. This means that there are very few questions about either or our topics. Both the quantitative and qualitative analyses would benefit from basic telehealth and transportation data from participants.
Conclusions: We need more research on these two topics among this population specifically. Clinics providing HIV care continuum services should consider clinical collection of quantitative data on telehealth and transportation. Interventions should be tailored to the individual. Research efforts should continue with further refinement and detail.
Table of Contents
Chapter 1. Introduction 1
1.1. Background 1
1.2. Needs 2
1.3. Goals 3
Chapter 2. Literature Review 4
2.1. General Issues of Healthcare-Related Transportation 5
2.2. General Issues of Telehealth 9
2.3. Telehealth and Transportation Among PWH and AAWH 14
Chapter 3. Methods 20
Chapter 4. Results 23
4.1. Survey Results 23
4.2. Interview Results 25
Chapter 5. Discussion 28
Chapter 6. Limitations 31
Chapter 7. Conclusions 34
Appendices. 35
Table 1 36
Table 2 38
Table 3 40
Table 4 42
References. 44
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