Telehealth Use Among Adults with Limited English Proficiency: Findings from the California Health Interview Survey

2023 · 3 citations

• Medicine
• Gerontology
• Family medicine

<h3>Context:</h3> Telehealth is an emerging technology lauded for its potential to improve healthcare access and utilization. The use of telemedicine increased dramatically due to the public health emergency resulting from COVID-19. Prior to the pandemic, there were significant disparities in access to telehealth for patients with limited English proficiency (LEP). <h3>Objective:</h3> To examine the association between limited English proficiency and telehealth use during the pandemic. <h3>Study Design and Analysis:</h3> We performed a secondary analysis of data from the 2021 California Health Interview Survey (CHIS). We used bivariate and multivariable logistic regression analyses to assess the association between limited English proficiency and telehealth use. The telehealth measure included telephone and video visits. Our analysis controlled for age, sex, race/ethnicity, marital status, education, federal poverty level, education, insurance type, self-reported health status, and whether patients had a usual source of care. <h3>Dataset:</h3> The adult population file of the 2021 California Health Interview Survey. <h3>Population:</h3> CHIS is a crosssectional survey of noninstitutionalized adults living in California aged 18 years and older. <h3>Outcome Measures:</h3> Descriptive statistics and adjusted odds ratios. <h3>Results:</h3> This study included 24,453 adult respondents. A total of 1,268 respondents reported limited English proficiency. Bivariate analysis revealed that adults who reported LEP had lower rates of telehealth use compared to those who were English proficient (38.0% to 50%). The adjusted odds (AOR) of telehealth use were lower among adults with limited English proficiency compared to those who were English proficient (AOR 0.68, p &lt; 0.001). Asian and Latino adults had lower adjusted odds of telehealth use compared to White adults (AOR 0.66, p &lt;0.001; AOR 0.89, p = 0.02, respectively). Adults without a usual source of care also had lower adjusted odds of telehealth use (AOR 0.31, p &lt;0.001). <h3>Conclusions:</h3> The results of this study highlight that adults with limited English proficiency experience disparities in access to telehealth use even after controlling for socioeconomic factors, access to care, and self-reported health status. These findings reiterate that health systems and policymakers should consider the needs of communities with limited English proficiency as we move toward an era of healthcare delivery inclusive of digital health technologies.

Testing the role of aerobic exercise in the treatment of posttraumatic stress disorder (PTSD) symptoms in U.S. active duty military personnel: a pilot study

Cognitive Behaviour Therapy · 2022 · 15 citations

• Medicine
• Physical therapy
• Psychology

< .0001); however, there were no significant differences between the experimental conditions. The prediction that imaginal exposure augmented with aerobic exercise would be superior to either imaginal exposure alone or aerobic exercise alone was not supported, suggesting that engaging in exercise and imaginal exposure simultaneously may not be any better than engaging in either activity alone. A better understanding of individually administered and combined exercise and exposure therapy interventions for PTSD is warranted.

Identifying suicidal subtypes and dynamic indicators of increasing and decreasing suicide risk in active duty military personnel: Study protocol

Contemporary Clinical Trials Communications · 2021 · 6 citations

• Medicine
• Psychiatry
• Clinical psychology

OBJECTIVES: Several recent studies have demonstrated that posttraumatic stress disorder (PTSD) and insomnia treatments are associated with significant reductions in suicidal ideation (SI) among service members. However, few investigations have evaluated the manner in which suicide risk changes over time among military personnel receiving PTSD or insomnia treatments. This paper describes the study protocol for a project with these aims: (1) explore potential genetic, clinical, and demographic subtypes of suicide risk in a large cohort of deployed service members; (2) explore subtype change in SI as a result of evidence-based psychotherapies for PTSD and insomnia; (3) evaluate the speed of change in suicide risk; and (4) identify predictors of higher- and lower-risk for suicide. METHODS: Active duty military personnel were recruited for four clinical trials (three for PTSD treatment and one for insomnia treatment) and a large prospective epidemiological study of deployed service members, all conducted through the South Texas Research Organizational Network Guiding Studies on Trauma and Resilience (STRONG STAR Consortium). Participants completed similar measures of demographic and clinical characteristics and subsets provided blood samples for genetic testing. The primary measures that we will analyze are the Beck Scale for Suicide Ideation, Beck Depression Inventory, and the PTSD Checklist for DSM-IV. DISCUSSION: Results from this study will offer new insights into the presence of discrete subtypes of suicide risk among active duty personnel, changes in risk over time among those subtypes, and predictors of subtypes. Findings will inform treatment development for military service members at risk for suicide.