Purpose

Rural cancer survivors have worse quality of life than their urban counterparts. Telemedicine is a potential solution to connecting rural residents with specialized cancer providers during the survivorship period, but limitations in broadband may stifle the impact. Using data from a feasibility study evaluating a telemedicine intervention aimed at connecting rural Virginia cancer survivors with their care team located at a cancer center associated with an academic medical center, we sought to evaluate the ability of rural survivors to access the intervention and suggest strategies for improving access to rural cancer survivorship care.

Methods

We used a descriptive design with geospatial and quantitative methods to understand broadband access, driving time to a satellite telemedicine site, and ability to utilize a borrowed cellular-enabled tablet to participate in the intervention for cancer survivors living in Central Virginia.

Results

Our study participants resided in census tracts where an average of 58% of households have adequate broadband access necessary to support a telemedicine videoconferencing intervention. Average driving time to the nearest telemedicine site was 29.6 min. Those who utilized the borrowed tablet experienced considerable difficulty with utilizing the technology.

Conclusions

Rural cancer populations do not have equal access to a cancer survivorship telemedicine intervention.

Implications for Cancer Survivors

Telemedicine interventions aimed at connecting cancer survivors with their academic medical center-based cancer providers may be ineffective if survivors do not have access to either fixed broadband or a satellite clinic. Future research needs to evaluate other sites from which rural survivors can connect, such as rural public libraries.

中文翻译：

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超越宽带：数字包容是导致农村癌症医疗服务不平等的驱动因素。

目的

农村癌症幸存者的生活质量比城市癌症幸存者差。远程医疗是在生存期间将农村居民与专门的癌症提供者联系起来的潜在解决方案，但是宽带的限制可能会扼杀这种影响。我们使用一项可行性研究的数据来评估远程医疗干预措施，该干预措施旨在将弗吉尼亚州的农村癌症幸存者与位于与学术​​医疗中心相关联的癌症中心的护理团队联系起来，我们试图评估农村幸存者进行干预的能力，并提出相应的策略改善获得农村癌症幸存护理的机会。

方法

我们使用具有地理空间和定量方法的描述性设计来了解宽带访问，到卫星远程医疗站点的开车时间，以及利用借来的支持蜂窝功能的平板电脑参与对弗吉尼亚州中部癌症幸存者的干预的能力。

结果

我们的研究参与者居住在人口普查区，在那里平均58％的家庭拥有支持远程医疗视频会议干预所必需的足够宽带接入。到最近的远程医疗站点的平均行驶时间为29.6分钟。使用借来的平板电脑的人在使用该技术时遇到了相当大的困难。

结论

农村癌症人群没有平等机会获得癌症幸存者远程医疗干预。

对癌症幸存者的影响

如果幸存者无法使用固定宽带或卫星诊所，那么将癌症幸存者与他们的学术医疗中心癌症提供者联系起来的远程医疗干预措施可能无效。未来的研究需要评估农村幸存者可以连接的其他站点，例如农村公共图书馆。