Disability and Telehealth: �Healthcare Access and Motivations

2020 Peachtree Road, NW, Atlanta, GA 30309-1465 | 404-352-2020 | shepherd.org

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March 13, 2023

Raeda Anderson^{1 2}, Suveyda Karakaya¹,

Elorm Adzadi^{1 3}, J’Lyn Martin^{1 4}, and John Morris¹

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¹ Shepherd Center ² Georgia State University

³ University of Georgia ⁴ Kennesaw State University

ACKNOWLEDGEMENTS

This study is funded by The Rehabilitation Engineering Research Center for Information and Communications Technology Access (LiveWell RERC) is funded by a 5-year grant from the National Institute on Disability, Independent Living and Rehabilitation Research in the U.S. Department of Health and Human Services (grant number 90RE5028).  

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The opinions contained in this presentation are those of the LiveWell RERC and do not necessarily reflect those of the U.S. Department of Health and Human Services or NIDILRR.

ACKNOWLEDGEMENTS

Georgia Research Alliance offers undergraduate and graduate students in Georgia a way to gain invaluable experience working in a research lab alongside a top scientist.

The GRA Student Scholars program, and it recruits students from across the state for real hands-on experience in the summer.

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Additional “thank you”

• Our study participants through the AURC
• Our colleagues: Ben Lippincott, Delaney Cowart, Sarah Mosely, Cathy Furbish

Telehealth: Healthcare Access and Motivations

BACKGROUND: COVID-19 AND TELEHEALTH

• The COVID-19 pandemic led to a rapid increase of online engagement overall, and for (Anderson et al. 2022)
• Rapid increase in telehealth use since the onset of the COVID-19 pandemic (Haynes et al. 2021)
• Increased telehealth use revealed barriers and facilitators, especially for people with disabilities (Haynes et al. 2021)

BACKGROUND: DISABILITY AND HEALTHCARE

• People with disabilities experience significant disparities in access to health care (Friedman and VanPuymbrouck 2021; Valdez et al. 2021)
• Healthcare, including communicating with medical staff and therapeutic appointments, is an important factor in reducing adverse health events for people with disabilities (Okoro et al. 2016)
• Telehealth, or telemedicine, is the primary method to communicate health problems and performing health assessments (Okoro et al. 2016)

This Photo by Unknown Author is licensed under CC BY-NC

GOALS OF THIS STUDY

Explore the relationship between disability type and other demographic variables and patterns of telehealth use and motivations for telehealth use

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Specifically, this study examines …

• Motivators to use telehealth ​
• Technology devices used during telehealth session​
• Types of healthcare received during telehealth session

DATA

• Telehealth, Disability, and Identity Survey (2022)
• Convenience sample
• Accessibility User Research Collective (AURC) & Consumer Advisory Network
• 1,300+ adults with disabilities across the United States of America
• 326 AURC members completed the survey (response rate of 31.68%)
• Pairwise deletion was used with a final analytical n= 251 respondents
• Descriptive statistics, measures of association, and logistic regression ​

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MEASURES

• Telehealth Use

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SAMPLE

Disability

• Walking: 34.7%
• Anxiety: 27.2%
• Learning Disability: 25.2%
• Upper Extremity limitation: 24.8%
• Fatigue & Limited Stamina: 24.3%
• Blind: 20.5%
• Deaf : 17.8%
• Speaking: 11.9%

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Demographics

• Woman: 52.8%
• Racial Minority (non-white): 23.9%
• Bachelor’s degree or more: 67.3%
• Age: M=51.09 (SD=14.21)

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RESULTS: TELEHEALTH USE

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RESULTS: TELEHEALTH USE

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RESULTS: TELEHEALTH MOTIVATORS

COVID-19.

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Time.

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51

Deaf

Upper Extremity

34

64

Transportation. (expanded on next slide)

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0%

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RESULTS: TELEHEALTH MOTIVATORS

Transportation

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Blind

Upper

Extremity

32

45

48

Fatigue

Walking

45

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RESULTS: DEVICES USED

Smart Phone

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Laptop Computer

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Blind

Learning Disabilities

75

Desktop Computer

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49

88

88

65

Deaf

63

62

Learning Disabilities

50

50

10

32

46

Upper Extremity

Walking

Speaking

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RESULTS: HEALTHCARE RECEIVED

General Health Check-ups

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Specialist Health Check-ups

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50

Blind

77

Psychological Counseling

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57

38

Overall

68

63

Walking

60

Worrying

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LIKELIHOOD OF USING TELEHEALTH BY DISABILITY TYPE

Blind (0.42)

Decreased

Increased

Only reporting statistically significant disability types

Deaf (0.87)

Fatigue (2.22)

Walking (3.85)

Upper Extremity Limitations (5.50)

Analysis: Odds Ratio logistic regression

DV: Telehealth Use

IV: Disability Type

Control variables: rurality, language spoken in home, education, income, disability duration, and age

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CONCLUSIONS

• Major findings:
• Telehealth use differs across disability types.
• People with mobility disabilities are more likely to use telehealth.
• People who are blind, deaf, or have a speaking disability are less likely to use telehealth.
• Policy implications:

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CONCLUSIONS

• Major findings:
• Telehealth use differs across disability types.
• People with mobility disabilities are more likely to use telehealth.
• People who are blind, deaf, or have a speaking disability are less likely to use telehealth.
• Policy implications:
• Based on the findings that people who have a speaking disability are less likely to use telehealth, there should be more resources allocated to improve accessibility needs for people with speaking disabilities.
• Increased integration of assistive technology into telehealth services for people who are blind, deaf, or have a speaking disability.

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JOIN THE AURC

https://accessibilityuserresearchcollective.org/

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CONTACT INFORMATION

Dr. Raeda K. Anderson: Raeda.Anderson@Shepherd.org

Dr. John T. Morris: John.Morris@Shepherd.org

AURC: AURC@Shepherd.org

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WORKS CITED

Friedman, Carli, and Laura VanPuymbrouck. “Telehealth Use by Persons with Disabilities During the COVID-19 Pandemic.” International Journal of Telerehabilitation vol. 13, no. 2, 2021, pp. 1-14.

Haynes, Norrisa, Agnes Ezekwesili, Kathryn Nunes, Edvard Gumbs, Monique Haynes & JaBaris Swain. “Can You See My Screen? Addressing Racial and Ethnic Disparities in Telehealth.” Current Cardiovascular Risk Reports, vol. 15, no. 12, 2021, pp. 15-23.

Lee, Nicol Turner, Jack Karsten, and Jordan Roberts. “Removing Regulatory Barriers to Telehealth Before and After COVID-19.” Brookings Institution, 2020, pp. 1-23.

Mitchell, Uchechi A., Perla G. Chebli, Laurie Ruggiero, and Naoko Muramatsu. “The Digital Divide in Health-Related Technology Use: The Significance of Race/Ethnicity.” The Gerontologist vol. 59, no. 1, 2019, pp. 6-14.

Sechrist, Samantha, Sarah Lavoie, Cria-May Khong, Benjamin Dirlikov, and Kazuko Shem the COVID-19 Pandemic.” International Journal of Telerehabilitation vol. 13, no. 2, 2021, pp. 1-14.

Valdez, Rupa S, Courtney C Rogers, Henry Claypool, Lucy Trieshmann, Olivia Frye, Claire Wellbeloved-Stone, Poorna Kushalnagar. “Ensuring Full Participation of People with Disabilities in an Era of Telehealth.” Journal of the American Medical Informatics Association, vol. 28., no. 2, 2021, pp. 389-392.

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Paper published in the Journal on Technology and Persons with Disabilities

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