Patient and Provider Perceptions of COVID-19-Driven Telehealth Use From Nurse-Led Care Models in Rural, Frontier, and Urban Colorado Communities

Amy J Barton; Claudia R Amura; Emileigh L Willems; Rosario Medina; Sophia Centi; Teri Hernandez; Sean M Reed; Paul F Cook

doi:10.1177/23743735231151546

Patient and Provider Perceptions of COVID-19-Driven Telehealth Use From Nurse-Led Care Models in Rural, Frontier, and Urban Colorado Communities

J Patient Exp. 2023 Jan 25:10:23743735231151546. doi: 10.1177/23743735231151546. eCollection 2023.

Authors

Amy J Barton¹, Claudia R Amura¹, Emileigh L Willems², Rosario Medina¹, Sophia Centi¹, Teri Hernandez^{1

3

4}, Sean M Reed¹, Paul F Cook¹

Affiliations

¹ University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA.
² Department of Biostatistics & Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
³ Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes. University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
⁴ Children's Hospital Colorado, Anschutz Medical Campus, Aurora, CO, USA.

Abstract

The purpose of this study was to characterize the patient and provider engagement in the sudden telehealth implementation that occurred with the onset of the COVID-19 pandemic. Patients and providers from 3 nurse-led models of care (federally qualified health centers, nurse midwifery practices, and the Nurse-Family partnership program) in Colorado were surveyed. Data from the Patient Attitude toward Telehealth survey and Provider Perceptions about Telehealth were collected. Patient respondents (n = 308) who resided primarily in rural or frontier communities were female, white, and Hispanic. Patients in urban areas used telehealth more frequently than in rural or frontier areas (P < .001). Rural/Frontier patients had significantly lower attitude scores than urban patients across each of 5 domains assessed. Telehealth modality differed across location (P < .023), with video calls, used more frequently by urban providers, and phone calls used by rural/frontier providers. Our data highlight differences in telehealth access and attitudes across rurality. These findings may contribute to future policy while addressing barriers to telehealth access and delivery.

Keywords: nurse models of care; practice patterns; rural health services; telehealth; vulnerable populations.

Grants and funding

R01 HS028085/HS/AHRQ HHS/United States