Enabling Rural Telehealth for Older Adults in Underserved Rural Communities: Focus Group Study

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dc.citation.issue11
dc.citation.volume6
dc.contributor.authorHunter I
dc.contributor.authorLockhart C
dc.contributor.authorRao V
dc.contributor.authorTootell B
dc.contributor.authorWong S
dc.coverage.spatialCanada
dc.date.accessioned2024-06-26T01:10:48Z
dc.date.available2024-06-26T01:10:48Z
dc.date.issued2022-11-04
dc.description.abstractBackground: Telehealth is often suggested to improve access to health care and has had significant publicity worldwide during the COVID-19 pandemic. However, limited studies have examined the telehealth needs of underserved populations such as rural communities. Objective: This study aims to investigate enablers for telehealth use in underserved rural populations to improve access to health care for rural older adults. Methods: In total, 7 focus group discussions and 13 individual interviews were held across 4 diverse underserved rural communities. A total of 98 adults aged ≥55 years participated. The participants were asked whether they had used telehealth, how they saw their community’s health service needs evolving, how telehealth might help provide these services, and how they perceived barriers to and enablers of telehealth for older adults in rural communities. Focus group transcripts were thematically analyzed. Results: The term telehealth was not initially understood by many participants and required an explanation. Those who had used telehealth reported positive experiences (time and cost savings) and were likely to use telehealth again. A total of 2 main themes were identified through an equity lens. The first theme was trust, with 3 subthemes—trust in the telehealth technology, trust in the user (consumer and health provider), and trust in the health system. Having access to reliable and affordable internet connectivity and digital devices was a key enabler for telehealth use. Most rural areas had intermittent and unreliable internet connectivity. Another key enabler is easy access to user support. Trust in the health system focused on waiting times, lack of and/or delayed communication and coordination, and cost. The second theme was choice, with 3 subthemes—health service access, consultation type, and telehealth deployment. Access to health services through telehealth needs to be culturally appropriate and enable access to currently limited or absent services such as mental health and specialist services. Accessing specialist care through telehealth was extremely popular, although some participants preferred to be seen in person. A major enabler for telehealth was telehealth deployment by a fixed community hub or on a mobile bus, with support available, particularly when combined with non–health-related services such as internet banking. Conclusions: Overall, participants were keen on the idea of telehealth. Several barriers and enablers were identified, particularly trust and choice. The term telehealth is not well understood. The unreliable and expensive connectivity options available to rural communities have limited telehealth experience to phone or patient portal use for those with connectivity. Having the opportunity to try telehealth, particularly by using video, would increase the understanding and acceptance of telehealth. This study highlights that local rural communities need to be involved in designing telehealth services within their communities.
dc.description.confidentialfalse
dc.edition.editionNovember 2022
dc.format.paginatione35864-
dc.identifier.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/36331533
dc.identifier.citationHunter I, Lockhart C, Rao V, Tootell B, Wong S. (2022). Enabling Rural Telehealth for Older Adults in Underserved Rural Communities: Focus Group Study.. JMIR Form Res. 6. 11. (pp. e35864-).
dc.identifier.doi10.2196/35864
dc.identifier.eissn2561-326X
dc.identifier.elements-typejournal-article
dc.identifier.issn2561-326X
dc.identifier.numbere35864
dc.identifier.piiv6i11e35864
dc.identifier.urihttps://mro.massey.ac.nz/handle/10179/70008
dc.languageeng
dc.publisherJMIR Publications
dc.publisher.urihttps://formative.jmir.org/2022/11/e35864/
dc.relation.isPartOfJMIR Form Res
dc.rights(c) 2022 The Author/s
dc.rightsCC BY 4.0
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectaccess
dc.subjectbarrier
dc.subjectbarriers
dc.subjectchoice
dc.subjecteHealth
dc.subjectelder
dc.subjectenabler
dc.subjectenablers
dc.subjectequity
dc.subjectfacilitator
dc.subjectfocus group
dc.subjectolder adult
dc.subjectrural
dc.subjecttelehealth
dc.subjecttelemedicine
dc.subjecttrust
dc.subjectunderserved
dc.subjectunderserved populations
dc.titleEnabling Rural Telehealth for Older Adults in Underserved Rural Communities: Focus Group Study
dc.typeJournal article
pubs.elements-id455553
pubs.organisational-groupOther
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