Demystifying the Digital Divide: Disparities in Telerehabilitation Readiness Among Older Adults in the United States.
Jason R Falvey, Na Sun, Matthew J Miller and 2 others
PMID 38554795WHAT IT FOUND
Two in three older rehabilitation users were ready for video visits.
Readiness was significantly lower among Black, Hispanic, financially strained, and rural patients. Lack of device ownership or tech skills, not sensory loss, was the main barrier.
Key findings
01Only 66% of older home and community-based rehabilitation users were considered ready for video-based telerehabilitation.
02Readiness was substantially lower among Black (39%), Hispanic (49%), and other minoritized racial/ethnic groups (34%) compared to non-Hispanic White users (61%).
03The primary driver of unreadiness across all groups was low technology ownership and proficiency, rather than sensory or cognitive impairments.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study only included people who had already received rehabilitation services, which may underestimate the true prevalence of unreadiness in the general population. Readiness was defined based on potential barriers to video visits, not actual patient preference or success with telerehabilitation. The analysis did not account for intersectionality (e.g., being both Black and financially strained) due to small sample sizes in some subgroups. Most data was collected pre-pandemic, so current technology access and comfort levels may differ.
Declared interests
Dr. Mullins reports consulting relationships with Bayer Healthcare, Rocket, and Takeda, which are unrelated to this study. The work was supported by the National Institute on Aging.
The easy way to misread this
Do not interpret 'readiness' as a measure of clinical effectiveness or patient preference. This study identifies who is likely to have the tools and ability to join a video visit, not who would benefit most from one. A patient marked 'unready' due to lack of a smartphone might still be highly motivated and capable if provided with a tablet or phone support.