Patient Factors Associated with Interest in Teledermatology: Cross-sectional Survey

• Type of Material: Article
• Authors: Maham Ghani, City University of New York; Colin Adler, Emory University; Howa Yeung, Emory University
• Language: English
• Date: 2021-01-01
• Publisher: JMIR
• Publication Version: Final Published Version
• Copyright Statement: ©Maham Ghani, Colin Adler, Howa Yeung. Originally published in JMIR Dermatology (http://derma.jmir.org), 10.05.2021.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.2196/21555
• Title of Journal or Parent Work: JMIR Dermatology
• Volume: 4
• Issue: 1
• Start Page: e21555
• End Page: e21555
• Grant/Funding Information: This study was supported in part by the Dermatology Foundation and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (L30 AR076081) (HY). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Department of Veterans Affairs.
• Keywords: teledermatology; e-health literacy; modifiable behaviors; Internet; digital divide
• Research Categories: Health Sciences, Health Care Management

Abstract

Background: Teledermatology is a conduit for patients communicating with dermatologists on the internet, which bypasses in-person visits. It holds promise to address access needs for dermatologic care; however, the interest in using teledermatology is unknown in underserved populations with potential barriers to the use of health care technology. Objective: This study aimed to characterize the association between demographic characteristics with interest in exchanging digital images or videos of skin lesions with health care providers electronically. Methods: We examined data from the Health Information National Trends Survey (HINTS) 4 cycle 4 (2014) of the National Cancer Institute. HINTS is a cross-sectional, nationally representative household survey conducted annually, which collects information on demographics, perceptions and use of health information, and provides information on how cancer risks are perceived. HINTS 4 cycle 4 had a sample of 3677 participants. We examined the outcome to the question, “how interested are you in exchanging digital images or videos (eg, photos of skin lesions) with a health care provider electronically?” We dichotomized the outcome by a high level of interest (responding with “very”) and those who did not have a high level of interest (responding with “somewhat,” “a little,” or “not at all”) in exchanging images or videos. We used a multivariable logistic regression model developed through backwards selection, with all final covariates associated with varying levels of teledermatology use at P<.05. Sensitivity analysis was performed by changing the outcome dichotomy to model those who were “not at all” interested. Two-sided tests were performed with P<.05 considered significant. Results: Among 3447 respondents, 888 (weighted prevalence=26.2%) were “very” interested in participating in teledermatology. A higher interest in using teledermatology was associated with a younger age, higher educational attainment, higher household income, internet usage, type of mobile device ownership, history of electronic medical information exchange with a clinician within the past 12 months, and high level of trust in web-based information on cancer (for all, P<.01), but not with the female gender, race or ethnicity, health insurance status, or having a regular medical provider. Conclusions: Modifiable access barriers to teledermatology adoption include trust, experience with teledermatology, and use of health apps. Teledermatology program implementation should address these specific factors within the digital divide to promote equitable access to care across diverse patient populations.