Socio-Structural Intersect With Post-COVID-19 Telehealth Utilization for Hispanic/Latino Groups in Colorado: A Mixed Methods Study

Abstract

Introduction: We evaluated telehealth utilization among Colorado Hispanics/Latinos during the COVID-19 pandemic. Methods: A mixed methods design was used with urban and rural patients recruited through two Colorado Federally Qualified Health Centers (FQHCs) serving large Hispanic/Latino communities. Linguistically and culturally adapted Patient Attitudes Toward Telehealth (PATAT) surveys were collected electronically. Semi-structured interviews were conducted with a purposeful sample of Spanish-speaking Hispanics/Latinos. Results: Although the FQHCs serve a Hispanic/Latino population, only 40% of survey respondents (82/204) were Hispanic/Latinos, and they reported less telehealth utilization ( p < .01). Trust in telehealth seemed driven by previous use, with no differences in PATAT scores by ethnicity or geolocation. Interviews with Spanish-speaking Hispanics/Latinos showed they highly preferred in-person care, and factors that influenced telehealth utilization were situated within the intersection of culture and trust with socio-structural determinants of health. Discussion: Resolving disparities in telehealth utilization requires patient-centric approaches and equitable transcultural care for underserved Hispanic/Latino populations.