TY - JOUR
T1 - Demographic differences between patients selecting video or telephone for contraceptive counseling via telehealth
AU - Freeman, Emily
AU - Paul, Rachel
AU - Dorsey, Megan
AU - Nigaglioni Rivera, Adriana
AU - Reeves, Jennifer A.
AU - Madden, Tessa
N1 - Publisher Copyright:
© 2024 Elsevier Inc.
PY - 2025/1
Y1 - 2025/1
N2 - Objective: To explore differences in demographic characteristics and telehealth usability between patients who chose video versus telephone for telehealth contraceptive counseling. Study design: This was a secondary analysis of a prospective cohort comparing the interpersonal quality of contraceptive counseling between in-person and telehealth visits at a single Title X-funded clinic. Before the clinical visit, a non-clinician counselor provided structured contraceptive counseling based on patients’ preferred modality. After counseling, respondents completed an electronic survey which included the Telehealth Usability Questionnaire (TUQ). Post-visit, the counselor evaluated perceived patient engagement. We calculated Area Deprivation Index (ADI) percentiles to characterize neighborhood environment. We compared characteristics between patients choosing video and telephone using Poisson regression and performed analyses stratified by ADI to test for effect modification. Results: Between March 2021 and June 2022, we enrolled 149 patients in the telehealth group: 146 (98%) were included in the analysis. Seventy percent of respondents chose telephone. Higher ADI, Black race, and lower educational level (<4 years college) were associated with choosing telephone in the unadjusted analysis. However, after stratifying by ADI, only lower educational level remained associated with choice of telephone among respondents from more deprived neighborhoods (aRR 1.46, 95% CI 1.01–2.11). We observed no differences in TUQ scores between respondents choosing telephone and video. Conclusion: When given the option, more patients selected telephone than video for telehealth contraceptive counseling. No demographic characteristics were associated with choice of telephone among patients with a higher ADI. Offering telephone-based telehealth may improve access for people seeking contraceptive services. Implications: We found that telephone-based telehealth is preferable for some patients, which may reflect differences in access to or comfort with video technology. We observed that higher ADI, Black race, and lower education level were associated with choice of telephone, although not after stratifying by ADI. Utilization of telephone-based telehealth may improve access for some patients and lead to more equitable-based health care.
AB - Objective: To explore differences in demographic characteristics and telehealth usability between patients who chose video versus telephone for telehealth contraceptive counseling. Study design: This was a secondary analysis of a prospective cohort comparing the interpersonal quality of contraceptive counseling between in-person and telehealth visits at a single Title X-funded clinic. Before the clinical visit, a non-clinician counselor provided structured contraceptive counseling based on patients’ preferred modality. After counseling, respondents completed an electronic survey which included the Telehealth Usability Questionnaire (TUQ). Post-visit, the counselor evaluated perceived patient engagement. We calculated Area Deprivation Index (ADI) percentiles to characterize neighborhood environment. We compared characteristics between patients choosing video and telephone using Poisson regression and performed analyses stratified by ADI to test for effect modification. Results: Between March 2021 and June 2022, we enrolled 149 patients in the telehealth group: 146 (98%) were included in the analysis. Seventy percent of respondents chose telephone. Higher ADI, Black race, and lower educational level (<4 years college) were associated with choosing telephone in the unadjusted analysis. However, after stratifying by ADI, only lower educational level remained associated with choice of telephone among respondents from more deprived neighborhoods (aRR 1.46, 95% CI 1.01–2.11). We observed no differences in TUQ scores between respondents choosing telephone and video. Conclusion: When given the option, more patients selected telephone than video for telehealth contraceptive counseling. No demographic characteristics were associated with choice of telephone among patients with a higher ADI. Offering telephone-based telehealth may improve access for people seeking contraceptive services. Implications: We found that telephone-based telehealth is preferable for some patients, which may reflect differences in access to or comfort with video technology. We observed that higher ADI, Black race, and lower education level were associated with choice of telephone, although not after stratifying by ADI. Utilization of telephone-based telehealth may improve access for some patients and lead to more equitable-based health care.
KW - Contraceptive
KW - Counseling
KW - Disparities
KW - Telehealth
UR - http://www.scopus.com/inward/record.url?scp=85204797554&partnerID=8YFLogxK
U2 - 10.1016/j.contraception.2024.110699
DO - 10.1016/j.contraception.2024.110699
M3 - Article
C2 - 39233023
AN - SCOPUS:85204797554
SN - 0010-7824
VL - 141
JO - Contraception
JF - Contraception
M1 - 110699
ER -