Objective: Telemedicine has gained popularity as an approach to improve health outcomes by enhancing care delivery to vulnerable populations. However, research is lacking on minority patient preferences for telemedicine, to whom these interventions would likely be offered. In this study, we explored opinions of ethnically diverse, underserved YA with T1D on the use of telemedicine videoconferencing for medical visits.
Methods: We conducted semi-structured interviews in 41 YA, ages 18-25, at a major diabetes center in the Bronx, NY. We audio-recorded, transcribed, and coded interviews using content analysis. We achieved thematic saturation.
Results: YA participants (53% female, 96% Black or Hispanic, 88% Medicaid) were 21±2.4 yrs, with T1D duration 11±2.3 yrs and mean HbA1c 9.6±1.2%. We found that the overwhelming majority of participants preferred to meet with their healthcare provider in person. Participants cited 3 major reasons for preference of in-person over telemedicine visits: 1) in-person visits felt more personal; 2) meeting in clinic helped YA feel more focused and accountable for past and future diabetes management (particularly if they liked their provider); and 3) it was easier to communicate diabetes issues person-to-person. Few stated a preference for telemedicine visits, however noted convenience and not having to navigate transportation as benefits. Notably, some participants would consider virtual communication with providers between visits, but preferred standard visits to remain in clinic.
Conclusions: In this sample of ethnically diverse, underserved YA with T1D, telemedicine visits were not well-accepted. Participants suggested that virtual visits would not provide the same comfort and investment in care as in-person visits. Future interventions using telemedicine as a new mode of care delivery in YA with T1D should consider minority patient preferences.
P.V. Commissariat: None. G. Crespo-Ramos: None. A. Jang: None. S. Agarwal: None.
National Institute of Diabetes and Digestive and Kidney Diseases (K23DK115896 to S.A.), (P30DK036836 to P.V.C.)