Background: Despite the United States having one of the leading health care systems in the world, underserved minority communities face significant access challenges. These communities can benefit from telehealth innovations that promise to improve health care access and, consequently, health outcomes. However, little is known about the attitudes toward telehealth in these communities, an essential first step toward effective adoption and use. Objective: The purpose of this study is to assess the factors that shape behavioral intention to use telehealth services in underserved Hispanic communities along the Texas-Mexico border and examine the role of electronic health (eHealth) literacy in telehealth use intention. Methods: We used cross-sectional design to collect data at a community health event along the Texas-Mexico border. The area is characterized by high poverty rates, low educational attainment, and health care access challenges. Trained bilingual students conducted 322 in-person interviews over a 1-week period. The survey instrument assessed sociodemographic information and telehealth-related variables. Attitudes toward telehealth were measured by asking participants to indicate their level of agreement with 9 statements reflecting different aspects of telehealth use. For eHealth literacy, we used the eHealth Literacy Scale (eHEALS), an 8-item scale designed to measure consumer confidence in finding, evaluating, and acting upon eHealth information. To assess the intention to use telehealth, we asked participants about the likelihood that they would use telehealth services if offered by a health care provider. We analyzed data using univariate, multivariate, and mediation statistical models. Results: Participants were primarily Hispanic (310/319, 97.2%) and female (261/322, 81.1%), with an average age of 43 years. Almost three-quarters (219/298) reported annual household incomes below $20,000. Health-wise, 42.2% (136/322) self-rated their health as fair or poor, and 79.7% (255/320) were uninsured. The overwhelming majority (289/319, 90.6%) had never heard of telehealth. Once we defined the term, participants exhibited positive attitudes toward telehealth, and 78.9% (254/322) reported being somewhat likely or very likely to use telehealth services if offered by a health care provider. Based on multivariate proportional odds regression analysis, a 1-point increase in telehealth attitudes reduced the odds of lower versus higher response in the intention to use telehealth services by 23% (OR 0.77, 95% CI 0.73-0.81). Mediation analysis revealed that telehealth attitudes fully mediated the association between eHealth literacy and intention to use telehealth services. For a 1-point increase in eHEALS, the odds of lower telehealth use decreased by a factor of 0.95 (5%; OR 0.95, 95% CI 0.93-0.98; P<.001) via the increase in the score of telehealth attitudes. Conclusions: Telehealth promises to address many of the access challenges facing ethnic and racial minorities, rural communities, and low-income populations. Findings underscore the importance of raising awareness of telehealth and promoting eHealth literacy as a key step in fostering positive attitudes toward telehealth and furthering interest in its use.

This is the abstract only. Read the full article on the JMIR site. JMIR is the leading open access journal for eHealth and healthcare in the Internet age.

中文翻译：

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了解服务欠缺的西班牙裔边境社区使用远程医疗服务的意图：跨部门研究。

背景：尽管美国拥有世界领先的医疗保健系统之一，但服务不足的少数族裔社区仍面临着巨大的医疗服务挑战。这些社区可以受益于远程医疗创新，这些创新有望改善医疗保健的获取，从而改善健康状况。但是，对于这些社区对远程医疗的态度知之甚少，这是朝着有效采用和使用迈出的重要第一步。目的：本研究的目的是评估影响在得克萨斯州-墨西哥边境沿线服务不足的西班牙裔社区中使用远程医疗服务的行为意愿的因素，并研究电子健康（eHealth）素养在远程医疗使用意愿中的作用。方法：我们使用横断面设计在德克萨斯州-墨西哥边境的社区健康事件中收集数据。该地区的特点是高贫困率，低学历和医疗保健方面的挑战。经过培训的双语学生在1周的时间里进行了322次面对面采访。调查工具评估了社会人口学信息和与远程医疗有关的变量。通过要求参与者用9项陈述来说明他们对远程医疗的态度，这些陈述反映了远程医疗使用的不同方面，从而衡量了他们对远程医疗的态度。对于电子卫生保健素养，我们使用了电子卫生保健素养量表（eHEALS），这是一个8项量表，旨在衡量消费者对查找，评估和采取电子卫生保健信息的信心。为了评估使用远程医疗的意图，我们询问了参与者医疗保健提供者提供远程医疗服务的可能性。我们使用单变量，多变量，和调解统计模型。结果：参与者主要是西班牙裔（310/319，97.2％）和女性（261/322，81.1％），平均年龄为43岁。近四分之三（219/298）的家庭年收入低于20,000美元。在健康方面，有42.2％（136/322）对自己的健康状况进行“自我评估”，认为自己的健康状况是“好”或“差”，而79.7％（255/320）没有得到保险。绝大多数（289 / 319，90.6％）从未听说过远程医疗。一旦我们定义了术语，参与者就对远程医疗表现出积极的态度，并且78.9％（254/322）报告说，如果由医疗保健提供者提供，则可能或非常可能使用远程医疗服务。根据多元比例优势回归分析，远程医疗态度每提高1点，使用远程医疗服务的意愿降低或降低的几率降低了23％（OR 0.77，95％CI 0.73-0.81）。中介分析显示，远程医疗态度完全协调了eHealth素养与使用远程医疗服务意图之间的关联。对于eHEALS的1分提高，通过远程医疗态度评分的提高，远程医疗使用率降低的几率降低了0.95（5％；或0.95，95％CI 0.93-0.98； P <.001）。结论：远程医疗有望解决少数民族和种族，农村社区和低收入人群所面临的许多接入挑战。调查结果强调了提高对远程医疗的认识和提高电子卫生保健素养的重要性，这是树立对远程医疗持积极态度并提高其使用兴趣的关键一步。中介分析显示，远程医疗态度完全协调了eHealth素养与使用远程医疗服务意图之间的关联。对于eHEALS的1分提高，通过远程医疗态度评分的提高，远程医疗使用率降低的几率降低了0.95（5％；或0.95，95％CI 0.93-0.98； P <.001）。结论：远程医疗有望解决少数民族和种族，农村社区和低收入人群所面临的许多接入挑战。调查结果强调了提高对远程医疗的认识和提高电子卫生保健素养的重要性，这是对远程医疗养成积极态度并提高其使用兴趣的关键一步。中介分析显示，远程医疗态度完全协调了eHealth素养与使用远程医疗服务意图之间的关联。对于eHEALS的1分提高，通过远程医疗态度评分的提高，远程医疗使用率降低的几率降低了0.95（5％；或0.95，95％CI 0.93-0.98； P <.001）。结论：远程医疗有望解决少数民族和种族，农村社区和低收入人群面临的许多接入挑战。调查结果强调了提高对远程医疗的认识和提高电子卫生保健素养的重要性，这是对远程医疗养成积极态度并提高其使用兴趣的关键一步。93-0.98；P <.001），因为远程医疗态度得分的提高。结论：远程医疗有望解决少数民族和种族，农村社区和低收入人群所面临的许多接入挑战。调查结果强调了提高对远程医疗的认识和提高电子卫生保健素养的重要性，这是对远程医疗养成积极态度并提高其使用兴趣的关键一步。93-0.98；P <.001），因为远程医疗态度得分的提高。结论：远程医疗有望解决少数民族和种族，农村社区和低收入人群所面临的许多接入挑战。调查结果强调了提高对远程医疗的认识和提高电子卫生保健素养的重要性，这是对远程医疗养成积极态度并提高其使用兴趣的关键一步。

这仅仅是抽象的。阅读JMIR网站上的全文。JMIR是互联网时代电子健康和医疗保健领域领先的开放获取期刊。