During the COVID-19 pandemic, access to convenient, quality care became an overnight issue. We saw a surge in telehealth options, including video counseling and virtual primary care visits. Research has found that these options enhanced (1) the ability to provide safe and timely care to high-risk and marginalized populations during the pandemic. In fact, one study showed that Black participants were more likely to report utilizing telehealth during the pandemic than their white counterparts.
Although telehealth has exploded in popularity, many areas of concern, such as new barriers (2) to accessing telehealth services and lack of digital literacy (3) skills, should continue to be investigated to guarantee continued equal access to this type of care. It’s essential to ensure these barriers do not prevent marginalized populations from fully participating and engaging in telehealth interventions. It’s also crucial to understand what factors are likely to enhance the utilization of telehealth services for marginalized populations and how digital options can be used to improve their health.
In recent research, Pack Health researchers measured changes in outcomes and engagement from baseline to 12 weeks of participation of individuals who are a part of a minority group. These observations took place to determine if the level of member engagement changes throughout the course of the program and if the member’s race and/or ethnicity played a role in that change.
As a part of participation, Pack Health members are matched with a Health Advisor who assists them in accomplishing their health goals with frequent accountability and support over a 12-week period. Pack Health members and their Health Advisors communicate weekly via email, text, or phone call (also known as touchpoints) about goal setting, condition-specific resources, and support.
Pack Health member data by race and ethnicity, including white, Black or African-American, and Asian members, was examined for similarities and differences in how members engaged with Pack Health programming and their post-intervention health outcomes. Patient-reported outcome data, such as health self-efficacy and improvements in mental health, were also reviewed to determine if the level of program engagement from members influenced any changes in their health outcomes.
- Black/African American members seemed to prefer to engage in different methods than other race and ethnic groups. While Black/African Americans spent less time on their weekly call with their Health Advisor than other race and ethnicity groups, they had the highest overall touchpoints indicating a preference for digital touchpoint methods.
- When comparing Hispanic or Latino to Non-Hispanic or Latino, a notable finding demonstrated that while the two groups spent nearly an identical amount of time on their weekly calls with their Health Advisor, engagement reciprocity from other engagement methods (I.e. text and email) was slightly lower among Hispanic or Latinos.
- Overall, members of two or more races had the highest engagement across mediums with Pack Health and saw the highest improvement in their physical health scores.
- Overall, White members spent the most time on the phone with the Health Advisor and saw the highest improvement in their mental health scores.
“These results reflect our members’ eagerness to engage and to remain engaged with our platform in order to accomplish their health goals,” says Stephen Burton, MS, Director of Data and Outcomes at Pack Health. “It’s helpful to see the preferences and outcomes among different member identities. This data is extremely valuable in showing ways we can continue to grow and ensure our members are consistently engaged in ways that match their preferences.”
- Campos-Castillo C, Anthony D. Racial and ethnic differences in self-reported telehealth use during the COVID-19 pandemic: a secondary analysis of a US survey of internet users from late March. J Am Med Inform Assoc. 2021;28(1):119-125. doi:10.1093/jamia/ocaa221
- Nouri S, Khoong EC, Lyles CR, Karliner L. Addressing equity in telemedicine for chronic disease management during the COVID-19 pandemic. NEJM Catalyst Innovations in Care Delivery. May 4, 2020. Accessed June 13, 2022. https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0123
- Shah SD, Alkureishi L, Lee, WW. Seizing the moment for telehealth policy and equity. Health Affairs blog. September 13, 2021. Accessed June 13, 2022. DOI: 10.1377/hblog20210909.961330