George Sheba, Hamilton Alison, Baker Richard S
Center for Biomedical Informatics, Charles R. Drew University of Medicine and Science, 2594 Industry Way, Lynwood, CA 90262, USA.
Int J Telemed Appl. 2012;2012:715194. doi: 10.1155/2012/715194. Epub 2012 Sep 10.
Introduction. Telemedicine is promoted as a means to increase access to specialty medical care among the urban underserved, yet little is known about its acceptability among these populations. We used components of a diffusion of innovation conceptual framework to analyze preexperience perceptions about telemedicine to assess its appeal among urban underserved African Americans and Latinos. Methods. Ten focus groups were conducted with African American (n = 43) and Latino participants (n = 44) in both English and Spanish and analyzed for key themes. Results. Both groups perceived increased and immediate access to multiple medical opinions and reduced wait time as relative advantages of telemedicine. However, African Americans expressed more concerns than Latinos about confidentiality, privacy, and the physical absence of the specialist. This difference may reflect lower levels of trust in new health care innovations among African Americans resulting from a legacy of past abuses in the US medical system as compared to immigrant Latinos who do not have this particular historical backdrop. Conclusions. These findings have implications for important issues such as adoption of telemedicine, patient satisfaction, doctor-patient interactions, and the development and tailoring of strategies targeted to each of these populations for the introduction, marketing, and implementation of telemedicine.
引言。远程医疗被视作一种增加城市弱势群体获得专科医疗服务机会的手段，但对于这些人群对其接受程度却知之甚少。我们运用创新扩散概念框架的组成部分，分析对远程医疗的前期体验认知，以评估其在城市非洲裔美国人和拉丁裔弱势群体中的吸引力。方法。针对非洲裔美国人（n = 43）和拉丁裔参与者（n = 44），用英语和西班牙语开展了10个焦点小组讨论，并对关键主题进行分析。结果。两组均认为，能增加并即时获得多种医疗意见以及缩短等待时间是远程医疗的相对优势。然而，相较于拉丁裔，非洲裔美国人对保密性、隐私性以及专科医生不在场等方面表达了更多担忧。这种差异可能反映出，与没有这一特定历史背景的移民拉丁裔相比，由于美国医疗系统过去存在的滥用行为，非洲裔美国人对新的医疗保健创新的信任程度较低。结论。这些发现对于远程医疗的采用、患者满意度、医患互动以及针对这些人群引入、推广和实施远程医疗的策略制定与调整等重要问题具有启示意义。
