Page 123 - IJPS-10-4

International Journal of
Population Studies Gender disparities in pandemic telehealth use

advantages of telehealth. Moreover, there is a digital literacy 2.2. Variables
gap, especially among older female users, which might 2.2.1. Telehealth use
deter them from embracing telehealth. A previous study
has highlighted the barriers among older female users in In this study, telehealth was defined as utilizing video-based
navigating online patient portals, primarily due to technical communication with health-care providers. Participants
difficulties (Zoorob et al., 2022). Similarly, research on were surveyed regarding their methods of communication
participation in telehealth trials for cardiovascular disease with their regular health-care providers before and during
risk found that females were more inclined than males to the COVID-19 outbreak. Response options included
refuse participation due to technological reasons (Foster “in-person visits,” “phone calls,” “emails/texts or portal
et al., 2015). The frustrations due to the recurring need messages,” and “video calls/telehealth,” with each option
for technical assistance throughout their use were also coded as yes = 1 or no = 0 for each category.
documented (Zoorob et al., 2022).
2.2.2. Technology access and knowledge
1.4. Objectives characteristics
The objective of this study is to investigate the usage status Technology access in this study refers to ownership of
and factors of telehealth among male and female adults digital devices, including having a working cell phone,
aged over 65 in the US during the COVID-19 pandemic. computer, or tablet, coded as yes = 1 or no = 0. Technology
Key research questions include: (i) What are the gender knowledge is defined as whether participants have learned
differences in telehealth usage among older adults before to use a new technology or program (e.g., smartphone,
and during the COVID-19 pandemic? (ii) how does computer, iPad, Zoom, or FaceTime) to access online
health status influence the relationship between gender services during the COVID-19 outbreak, also coded as
and telehealth usage during the pandemic? (iii) what yes = 1 or no = 0.
factors are associated with telehealth usage within each 2.2.3. Health characteristics
gender? We hypothesize that telehealth usage among older
adults increased during the COVID-19 pandemic for Participants’ overall self-reported health was assessed on a
both genders, albeit with differences between males and continuous scale ranging from 1 to 5, where a higher score
females. We further posit that the impact of gender on indicated poorer self-reported health. Multimorbidity was
telehealth usage is influenced by the health status of older defined as the presence of multiple chronic conditions,
adults. In addition, we anticipate that socioeconomically including heart diseases, arthritis, osteoporosis, diabetes,
advantaged older adults with better health and greater lung disease, stroke, dementia/Alzheimer’s disease, and
access to technology and knowledge will be more likely to cancer, coded as yes = 1 or no = 0.
engage in telehealth.
2.2.4. Sociodemographic characteristics
2. Methods Gender among NHATS participants was categorized
as “male” or “female.” Age was measured continuously.
2.1. Study population Race/ethnicity was categorized as “White,” “Black,”
The study utilized data from Round 10 (R10) and and “others.” Marital status was classified as “married/
COVID-19 supplement data from the National Health partnered,” “widowed,” and “unmarried.” Participants’
and Aging Trends Study (NHATS), a longitudinal study self-rated income was initially divided into four quartiles:
representing Medicare enrollees aged 65 and older living “< $23,750 (level 1),” “$23,750 ≤ × < $42,500 (level 2),”
in the US in 2011 and 2015. The survey collects annual “$42,500 ≤ × < $75,000 (level 3),” “≥ $75,001 (level 4).”
information on participants’ health, function, and An additional category, “missing income (level 5).”
technological environment. Data for NHATS R10 were Education level was categorized as “no or high school
collected via phone during the COVID-19 pandemic incomplete (level 1),” “completed high school (level 2),”
outburst. The NHATS participants who completed the “post-secondary education and some college (level 3),” and
sample person (SP) interview in R10 were subsequently “completed college and above (level 4).
mailed a supplemental COVID-19 questionnaire between
June 2020 and January 2021. Out of 3,961 SP who 2.3. Statistical analysis
completed the R10 interview, 3,257 participants or their First, univariate and bivariate analyses were conducted to
proxies completed the COVID-19 supplementary survey. present the characteristics of sociodemographics, health,
The NHATS data can be retrieved through official requests and methods of communication with health-care providers
made at https://www.nhats.org/researcher. among male and female older adults. Furthermore,

Volume 10 Issue 4 (2024) 117 https://doi.org/10.36922/ijps.1817