Prenatal telehealth use was low during early COVID-19 | Image Credit: © nenetus - © nenetus - stock.adobe.com.
Prenatal telehealth care was not commonly used among people who gave birth during the first year of the COVID-19 pandemic, according to a recent study published in JAMA Network Open.
- Prenatal telehealth care was not widely adopted by people giving birth during the first year of the COVID-19 pandemic, with approximately 1 in 3 participants using it.
- Rates of prenatal telehealth use did not significantly differ between respondents with private insurance and those with Medicaid, but those with no insurance were less likely to use it.
- Prenatal telehealth use was more common among Hispanic, Asian or Pacific Islander, and Indigenous respondents compared to non-Hispanic White respondents, as well as those living in urban areas vs rural areas.
- Personal preference was the most frequently cited reason for not using prenatal telehealth, followed by appointment availability, other reasons, and technological barriers.
- The study highlights the importance of considering patients' preferences when incorporating prenatal telehealth into their care, suggesting that it should be adapted to meet individual needs.
At the onset of the COVID-19 pandemic, many prenatal care clinicians incorporated virtual care into their practice. Studies have evaluated rates of access and satisfaction at single clinician sites and found mixed results, but data evaluating multiple clinical sites is lacking.
To evaluate prenatal telehealth use and reasons for nonuse within the first year of the COVID-19 pandemic, investigators conducted across-sectional study utilizing a multistate representative survey. Data across 29 sites was obtained from the 2020 Pregnancy Risk Assessment Monitoring System.
Participants included respondents of the COVID-19 experiences questionnaire during site-months with a response rate of at least 50% who provided informed consent. Having a prenatal telehealth visit was the primary outcome of the analysis, measured based on a binary indicator.
Secondary outcomes of the analysis included reasons for not using prenatal telehealth. Four reasons were determined: personal preference, appointment availability, technological barriers, and other reasons.
There were 12,073 respondents who gave birth from June to December 2020 included in the final analysis. Of respondents, 53% had private insurance, 54% were non-Hispanic White, and 87% lived in urban counties.
Use of prenatal telehealth was reported by approximately 1 in 3 participants. Rates of prenatal telehealth use did not differ between respondents with private insurance and those with Medicaid, but prenatal telehealth use was 14.6% less likely in those with no insurance.
Prenatal telehealth use was also more common in Hispanic, Asian or Pacific Islander, and Indigenous respondents compare to non-Hispanic White respondents, as well as those living in urban areas vs those living in rural areas.
Of participants who did not use prenatal telehealth, 70% reported personal preference as a reason, 26% reported no appointment availability, 14% reported other reason, and 5% reported technological barriers.
These results indicated low rates of prenatal telehealth use among people who gave birth within the first year of the COVID-19 pandemic, with personal preference as the most common reason for lack of use. Investigators concluded patients’ preferences should influence how prenatal telehealth is incorporated into their care.
Gourevitch RA, Anyoha A, Ali MM, Novak P. Use of prenatal telehealth in the first year of the COVID-19 pandemic. JAMA Netw Open. 2023;6(10):e2337978. doi:10.1001/jamanetworkopen.2023.37978