Barriers and Facilitators to Telehealth in Underserved Rural Communities: A Mixed‐Methods Formative Evaluation.
Background: Telehealth can mitigate healthcare access barriers that contribute to persistent rural health inequities. However, a limited understanding of telehealth barriers and preferences hinders the implementation of effective programs in rural communities. We conducted a formative evaluation to...
| Publicado en: | Health Expectations Vol. 29; no. 4; pp. 1 - 12 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Aug2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196480417&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196480417 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13696513 EVY jtl: Health Expectations issn: 13696513 maglogo: Y pubinfo: dt: Aug2026 vid: 29 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 196480417 196480417 196480417 10.1111/hex.70747 196480417 ppf: 1 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Barriers and Facilitators to Telehealth in Underserved Rural Communities: A Mixed‐Methods Formative Evaluation. aug: au: Terhune, Julia Holtz, Bree Ford, Sabrina Mitchell, Katharine M. Hornbogen, Charlie Hirko, Kelly A. affil: Department of Advertising and Public Relations, College of Communication Arts & Sciences, Michigan State University, East Lansing Michigan,, USA sug: subj: Telehealth Psychosocial Factors Medically Underserved Area Rural Population Health Services Accessibility Implementation Science Funding Source Michigan Human Male Female Adult Middle Age Aged Multimethod Studies Semi-Structured Interview Summated Rating Scaling Thematic Analysis Descriptive Statistics Income Internet Access Patient Satisfaction Computer Literacy Communication Professional-Patient Relations Trust Comfort Transportation Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Telehealth can mitigate healthcare access barriers that contribute to persistent rural health inequities. However, a limited understanding of telehealth barriers and preferences hinders the implementation of effective programs in rural communities. We conducted a formative evaluation to identify barriers and facilitators to telehealth adoption in an underserved rural setting. Methods: We used a mixed‐methods design including surveys and in‐depth semi‐structured interviews with rural community stakeholders. The survey assessed telehealth utilisation, perceptions, technology access and barriers using Likert‐type scales. Survey data were analysed descriptively, and interview data were examined thematically across the Unified Theory of Acceptance and Use of Technology (UTAUT) constructs. Findings: Survey respondents (n = 59) were primarily female (73.2%), and White (73.2%), with a mean age of 61 years. Over half (51.8%) reported annual incomes below $20,000, and 18.6% lacked home internet access. While 59.3% had heard of telehealth, only 42.4% had used it. Among users, 61.9% reported satisfaction, and 71.4% agreed or strongly agreed that communication with providers was adequate. Key barriers included limited internet connectivity (72.8%), technology challenges (66.6%) and lack of knowledge about accessing telehealth (62.5%). Interview participants (n = 8) emphasised that trust and comfort with providers were central to acceptance and highlighted telehealth's convenience in reducing transportation barriers. Conclusion: In this study population, telehealth was generally acceptable, with trust and comfort with the provider driving acceptance. Barriers were primarily related to connectivity, infrastructure and digital literacy. Consistent with larger studies, these findings support investments in broadband access, digital literacy, technical support and building patient confidence in virtual care. Patient or Public Contribution: Members of the public were involved in the design, recruitment and dissemination phases of this study. We partnered with local community organisations serving rural populations to inform recruitment strategies and to distribute surveys to community members with lived experience of healthcare access barriers. Community stakeholders also participated directly in the research through survey completion and in‐depth interviews, providing critical insights into telehealth use, barriers and preferences. While the public was not involved in the initial study design or data analysis, their perspectives shaped the interpretation of findings, particularly regarding trust, technology use and access challenges. To support dissemination and ensure accessibility of results, we developed a one‐page summary of findings that was shared with participating community partner sites for distribution back to the communities involved. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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