Associations between Perceived Ease of Use, Perceived Usefulness, and Telehealth Adoption Among Resettled Refugees during the COVID-19 Pandemic

Background and Purpose:

Telehealth services may offer an efficacious alternative to in-person healthcare, including for vulnerable populations and communities that have experiences persistent barriers to healthcare and related health disparities. Additionally, the COVID-19 pandemic necessitated a sweeping re-evaluation of the provision of healthcare services to diverse populations. Although not without challenges and limitations, telehealth may create opportunities for accessible, culturally responsive, and cost-effective care for historically minoritized populations, including refugees. This study aimed to understand the willingness of resettled refugees to use telehealth services and to explore the influencing factors on resettled refugees’ use of telehealth services in New York’s Capital District through a Technology Acceptance Model.

Methods:

The data were drawn from the Telehealth and COVID-19 Knowledge, Attitudes, and Practices in New York Refugee Communities Survey (N = 353), conducted March-May, 2022. The study employed a cross-sectional, structured survey that included multiple choice questions and Likert-type scale response options. Utilizing a Community-Based Participatory Research (CBPR) approach, collaborative partnership was established with Community Data Collectors (CDCs). CDCs administered electronic surveys through personal networks to local immigrant communities . The survey contained questions related to the participants’ perceptions and experiences with telehealth services during the COVID-19 pandemic.

Analyses were conducted using SPSS version 27. Descriptive statistics and correlations were first computed. Next, a binary logistic regression analysis was performed to predict resettled refugees’ willingness to use telehealth services from key independent variables (perceived usefulness and perceived ease of use). Control variables were sociodemographic variables such as age, gender, education, and health status.

Results:

In the multivariate analysis, willingness to use telehealth services in the future was significantly associated with perceived usefulness, perceived ease of use, and gender. Participants who had a positive perception toward the usefulness were 7x more likely to be willing to use telehealth services in the future (OR=7.03, p<0.01). Participants who had a positive perception toward the ease of use were 11x more likely to be willing to use telehealth services in the future (OR=11.06, p<0.01). Male participants were almost two times more likely to willing to use telehealth services in the future compared with female participants (OR=1.90, p<0.05). Health status, age, and education were not significantly associated with willingness to use telehealth services.

Conclusions and Implications:

The results from this study indicated that resettled refugees’ willingness to use telehealth services is directly and significantly influenced by perceived usefulness and perceived ease of use. Organizations providing telehealth services should provide adequate assistance and guidelines for population groups that are not familiar with new technologies.