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Factors Associated With Use of and Satisfaction With Telehealth by Adults in Rural Virginia During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

COVID-19 has accelerated the expansion of telehealth, heralding an opportunity to integrate technology into clinical care delivery in new and purposeful ways. However, there are disparities among people in rural communities that limit opportunities to gain experience and comfort using technology for health information and services, including lower home broadband access, lower health literacy, and less use of online health information compared with urban populations.1,2 In this survey study, we examine the use of and satisfaction with telehealth services during the pandemic in a predominantly rural sample and estimate the magnitude of the association between demographic and health characteristics, health literacy, internet access, and the odds of using telehealth.

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Article Information

Accepted for Publication: May 28, 2021.

Published: August 5, 2021. doi:10.1001/jamanetworkopen.2021.19530

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Thomson MD et al. JAMA Network Open.

Corresponding Author: Maria D. Thomson, PhD, Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, One Capitol Square, 4th Fl, Richmond, VA 23298 (maria.thomson@vcuhealth.org).

Author Contributions: Dr Thomson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Thomson, Sheppard.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: All authors.

Critical revision of the manuscript for important intellectual content: Thomson, Mariani, Williams, Sheppard.

Statistical analysis: Thomson, Mariani.

Obtained funding: Thomson, Sheppard.

Administrative, technical, or material support: Thomson, Williams, Sutton, Sheppard.

Supervision: Thomson, Sheppard.

Conflict of Interest Disclosures: None reported.

Funding/Support: This study was funded by the Virginia Commonwealth University Office of the Vice President for Research and Innovation and the C. Kenneth and Dianne Wright Center for Clinical and Translational Research.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Perrin  A . Digital gap between rural and nonrural America persists. Pew Research Center. Published May 31, 2019. Accessed July 1, 2021. https://www.pewresearch.org/fact-tank/2019/05/31/digital-gap-between-rural-and-nonrural-america-persists/
2.
Zahnd  WE , Scaife  SL , Francis  ML .  Health literacy skills in rural and urban populations.   Am J Health Behav. 2009;33(5):550-557. doi:10.5993/AJHB.33.5.8PubMedGoogle ScholarCrossref
3.
Parmanto  B , Lewis  AN  Jr , Graham  KM , Bertolet  MH .  Development of the Telehealth Usability Questionnaire (TUQ).   Int J Telerehabil. 2016;8(1):3-10. doi:10.5195/ijt.2016.6196PubMedGoogle ScholarCrossref
4.
Chew  LD , Griffin  JM , Partin  MR ,  et al.  Validation of screening questions for limited health literacy in a large VA outpatient population.   J Gen Intern Med. 2008;23(5):561-566. doi:10.1007/s11606-008-0520-5PubMedGoogle ScholarCrossref
5.
US Department of Agriculture Economic Research Service. Rural-urban continuum codes. Published December 10, 2020. Accessed July 1, 2021. https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/
6.
Sarkar  U , Karter  AJ , Liu  JY , Moffet  HH , Adler  NE , Schillinger  D .  Hypoglycemia is more common among type 2 diabetes patients with limited health literacy: the Diabetes Study of Northern California (DISTANCE).   J Gen Intern Med. 2010;25(9):962-968. doi:10.1007/s11606-010-1389-7PubMedGoogle ScholarCrossref
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