Telehealth use in cystic fibrosis during COVID-19: Association with race, ethnicity, and socioeconomic factors

• Published in: Journal of cystic fibrosis Vol. 20; pp. 49 - 54
• Main Authors: Albon, Dana, Van Citters, Aricca D., Ong, Thida, Dieni, Olivia, Dowd, Christopher, Willis, Anne, Sabadosa, Kathryn A., Scalia, Peter, Reno, Kimberly, Oates, Gabriela R., Schechter, Michael S.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2021; Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society
• Subjects: Communicable Disease Control - methods; Communication Barriers; COVID-19 - epidemiology; COVID-19 - prevention & control; Cystic Fibrosis - economics; Cystic Fibrosis - ethnology; Cystic Fibrosis - psychology; Cystic Fibrosis - therapy; Financial Stress - ethnology; Health Services Accessibility - organization & administration; Health Services Accessibility - trends; Healthcare Disparities - ethnology; Healthcare Disparities - standards; Humans; Minority Health - ethnology; Minority Health - standards; Minority Health - statistics & numerical data; Needs Assessment; Organizational Innovation; Racial/ethnic minorities; SARS-CoV-2; Socioeconomic Factors; Socioeconomic status; Telehealth; Telemedicine - organization & administration; Telemedicine - standards; United States - epidemiology; Vulnerable Populations - statistics & numerical data; United States; SES; CFF; Socioeconomic status; CF; Telehealth; PwCF; SoC1; CFCP; SARS-CoV-2; CFFPR; TH; TDI; Racial/ethnic minorities; PFSoC; CFTR
• ISSN: 1569-1993; 1873-5010
• DOI: 10.1016/j.jcf.2021.09.006

•PwCF from racial/ethnic minorities were less likely to have had a telehealth visit.•Telehealth use did not differ by health insurance or financial status.•PwCF who reported financial difficulties found TH more difficult to use.•CFCP perceived technology and language as barriers to TH in vulnerable populations. Due to the COVID-19 pandemic, there was an uptake of telehealth in cystic fibrosis care. Previous studies show disparities in telehealth use based on socioeconomic status (SES). We aimed to: (1) understand telehealth use and perceptions and (2) identify the facilitators and barriers to telehealth use among people with CF and their families (PwCF) from diverse racial/ethnic and socioeconomic backgrounds. We conducted an analysis of the 2020 Cystic Fibrosis State of Care surveys completed by PwCF (PFSoC), CF Care Programs (SoC1) and the CF Foundation Patient Registry (CFFPR). A total of 424 PwCF and 286 programs responded to the PFSoC and SoC1. Among PwCF, 90% self-identified as White, 6% as Hispanic/Latino, and 2% as Black. Racial/ethnic minorities were less likely to have had a telehealth visit (p=.015). This difference was pronounced among the Hispanic/Latino population (p<.01). Telehealth use did not differ by health insurance and was similarly offered independent of financial status. Compared to PwCF who denied financial constraints, those who reported financial difficulties found telehealth more difficult to use (p=.018) and were less likely to think that their concerns (p=.010) or issues that mattered most to them (p=.020) were addressed during telehealth. Programs perceived lack of technology, language barriers, and home conditions as barriers to telehealth in vulnerable populations. PFSoC and SoC1 identified differences in telehealth use and care perceptions by ethnicity, race, and socioeconomic characteristics. Further studies are needed to understand how telehealth can change access to CF care in diverse subpopulations.