Beyond broadband: digital inclusion as a driver of inequities in access to rural cancer care
- PDF / 1,346,625 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 14 Downloads / 180 Views
Beyond broadband: digital inclusion as a driver of inequities in access to rural cancer care Pam Baker DeGuzman 1,2 & Veronica Bernacchi 1 & C. Allen Cupp 2 & Brian Dunn 2 & B. J. Ferrebee Ghamandi 3 & Ivora D. Hinton 1 & Mark J. Jameson 2,3 & Debra Lynn Lewandowski 2 & Christi Sheffield 2 Received: 18 November 2019 / Accepted: 4 March 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Rural cancer survivors have worse quality of life than their urban counterparts. Telemedicine is a potential solution to connecting rural residents with specialized cancer providers during the survivorship period, but limitations in broadband may stifle the impact. Using data from a feasibility study evaluating a telemedicine intervention aimed at connecting rural Virginia cancer survivors with their care team located at a cancer center associated with an academic medical center, we sought to evaluate the ability of rural survivors to access the intervention and suggest strategies for improving access to rural cancer survivorship care. Methods We used a descriptive design with geospatial and quantitative methods to understand broadband access, driving time to a satellite telemedicine site, and ability to utilize a borrowed cellular-enabled tablet to participate in the intervention for cancer survivors living in Central Virginia. Results Our study participants resided in census tracts where an average of 58% of households have adequate broadband access necessary to support a telemedicine videoconferencing intervention. Average driving time to the nearest telemedicine site was 29.6 min. Those who utilized the borrowed tablet experienced considerable difficulty with utilizing the technology. Conclusions Rural cancer populations do not have equal access to a cancer survivorship telemedicine intervention. Implications for Cancer Survivors Telemedicine interventions aimed at connecting cancer survivors with their academic medical center-based cancer providers may be ineffective if survivors do not have access to either fixed broadband or a satellite clinic. Future research needs to evaluate other sites from which rural survivors can connect, such as rural public libraries. Keywords Cancer survivorship . Rural populations . Broadband access . Access to care . Telemedicine Since the publication of the Institute of Medicine (now National Academy of Medicine) 2005 comprehensive report From Cancer Patient to Cancer Survivor: Lost in Transition, there has been heightened awareness of how ill-equipped US cancer care delivery systems are to handle survivors’ longterm psychosocial, spiritual, sexual, and other treatmentrelated sequelae of cancer [1, 2]. Today, while the cancer care delivery community continues to struggle to implement the Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11764-020-00874-y) contains supplementary material, which is available to authorized users. * Pam Baker DeGuzman [email protected] 1
University of Virginia School of Nursing,
Data Loading...
