Communication Preferences Research Articles

Children’s Exposure Factors and Risk Perception of Sanitation Challenges Along the U.S.–Mexico Border

ABSTRACT In the rural U.S.–Mexico border towns, transboundary sanitary sewage overflows (SSOs) are of concern. The high concentrations of pathogens present in SSOs poses a threat to the shared ecosystem and communities’ health and well-being. Concerns related to an SSO effluent situated adjacent to a school in Naco, Arizona led to an academic-government-school partnership to assess children’s exposure factors, environment and health related risk perceptions, and risk communication preferences. A survey administered to school staff (n = 9) and parents (n = 31) observed a lower hand/object-to-mouth behavior for children ages 4–6 compared to values in the literature, and the need to further assess exposure factors for children over six. While there was a general negative risk perception to SSOs, approximately half of respondents did not have/were not sure of any SSO-related events. Using the Bioregion/One Health and cross-border governance frameworks, this study highlights the governing barriers that exist during SSO events and underscores the need for community participation, effective intervention, and risk communication strategies.

Deaf, deaf-blind, and hard of hearing needs and perceptions of community pharmacy services

Background: Deaf, deaf-blind, and hard of hearing (D/DB/HOH) individuals face communication challenges affecting their health, which can lead to medication errors. Pharmacists can mitigate medication-related errors for D/DB/HOH individuals, but there is a lack of evidence-based best practices. This study explored the experiences of D/DB/HOH people at a community pharmacy and offered practical solutions to improve pharmaceutical care for D/DB/HOH individuals. Methods: A qualitative study consisting of 5 focus group discussions occurred. Focus groups were formed based on participants’ ability to use sign language, their hearing ability, and their age. Results: Nineteen participants completed the study (8 HOH adults, 2 HOH seniors, 1 deaf-blind adult, 4 deaf adults, and 4 deaf seniors). Communication barriers depended on one’s hearing ability but included factors such as assuming one can hear, environmental noises around the pharmacy, pharmacists not knowing American Sign Language, and assuming individuals are proficient at reading English. Focus group participants shared the potential and actual impacts that communication barriers can have on health. Strategies to improve communication between hearing pharmacists and D/DB/HOH individuals are discussed. Discussion: This is the first study in Canada exploring D/DB/HOH individuals’ experiences at community pharmacies. Focus groups were effective at revealing the similarities and differences in pharmacy experience between D/DB/HOH folks, calling attention to access barriers and their impacts on health, and highlighting ways to better meet the needs of D/DB/HOH individuals. Conclusion: Communication barriers result in a lack of understanding of one’s medications. Pharmacists should ask about communication preferences and aim to reduce communication barriers for those who are D/DB/HOH.

Physician experiences of team-based clinical microsystems: implications for the future of inpatient interprofessional communication

ABSTRACT Healthcare clinical microsystems are small, goal-oriented groups of healthcare professionals that work together on a regular basis to provide care to discrete patient populations. They often include team-based frameworks such as bedside interprofessional rounds, geographic colocation of healthcare team members, interprofessional staff leadership, and unit-level data sharing. In inpatient settings, microsystems improve interprofessional communication and collaboration. In this qualitative study, we examined physician experiences of clinical microsystems and the mechanisms underpinning interprofessional communication in this environment. We interviewed 51 resident and hospitalist physicians. Thematic analysis of physician experiences revealed three key themes: (a) Clinical microsystem effect on workflow, (b) Open forum and work relationships, and (c) Face-to-face vs technology-based communication. Physicians described strong interprofessional relationships based on frequent face-to-face communication. Familiarity with healthcare team members, often resulting from being co-located to the same units, created a comfortable work environment, advanced patient care, and accelerated workflow. Physicians preferred in-person communication with interprofessional colleagues over technology-based communicationand described how in-person interactions enriched subsequent technology-led interactions. As the use of technology-based communication grows in inpatient settings, decreasing face-to-face interactions and facilitating dispersed care, understanding and implementing optimal conditions for effective interprofessional communication is essential.

Evaluating Tobacco Cessation Readiness in OPMD Patients Using the Transtheoretical Model in a tertiary care setting in Northeast India

Background: Oropharyngeal cancers pose significant global health challenges and addressing public awareness, early symptoms, and risk factors, alongside promoting tobacco cessation among individuals with potentially malignant oral disorders, is crucial for reducing the disease burden.Objective: Evaluating the degree of public knowledge of oral malignancy & OPMD, initial signs & risk factors amongst patients going to a dental college in North East India, as well as readiness to quit tobacco amongst OPMD patient.Methods: This cross-sectional investigation was undertaken at the Department of Public Health Dentistry, Tertiary care Hospital in Guwahati. 200 participants aged 15-65 years who consented were surveyed using a self-administered questionnaire. Collected data underwent thorough checks for completeness and accuracy. To determine the odd's ratio (OR) and to summarise the data, descriptive & inferential statistics were used. To test the relationship, data were dichotomised. Oral lesions present or absent; behavioural phases were divided into two categories: (preparation + action) & (precontemplation + contemplation). P < 0.05 was used as the statistical significance threshold.Results: Most participants were in the contemplation stage regarding tobacco's risks, neglecting other risk factors like alcohol & inadequate dental hygiene for oral malignancy/OPMD development.Conclusions: The lack of knowledge of oral malignancy & potentially malignant disorders (OPMDs) amongst North Eastern Indian communities, underscores the immediate demand for targeted education and health promotion campaigns. Emphasizing early symptom recognition, risk factors, and prevention measures, tailored to diverse communication preferences, is crucial.

Using neural style transfer to study the evolution of animal signal design: A case study in an ornamented fish

The sensory drive hypothesis of animal signal evolution describes how animal communication signals and preferences evolve as adaptations to local environments. While classical approaches to testing this hypothesis often focus on preference for one aspect of a signal, deep learning techniques like generative models can create and manipulate stimuli without targeting a specific feature. Here, we used an artificial intelligence technique called neural style transfer to experimentally test preferences for color patterns in a fish. Findings in empirical aesthetics show that humans tend to prefer images with the visual statistics of the environment because the visual system is adapted to process them efficiently, making those images easier to process. Whether this is the case in other species remains to be tested. We therefore manipulated how similar or dissimilar male body patterns were to their habitats using the Neural Style Transfer (NST) algorithm. We predicted that males whose body patterns are more similar to their native habitats will be preferred by conspecifics. Our findings suggest that both males and females are sensitive to habitat congruence in their preferences, but to different extents, requiring additional investigation. Nonetheless, this study demonstrates the potential of artificial intelligence for testing hypotheses about animal communication signals.

Communicating health risk in chronic kidney disease: a scoping review.

Communicating risk is a key component of shared decision-making and is vital for the management of advanced chronic kidney disease (CKD). Despite this, there is little evidence to suggest how best to communicate health risk information to people living with CKD. The aim of this review was to identify and understand the nature of evidence-based risk communication strategies for people living with CKD. We searched MEDLINE, CINAHL and Scopus databases for articles which described or evaluated the use of risk communication strategies within the renal population. Similar risk communication strategies were collated and summarised narratively. A total of 3700 sources were retrieved from the search, of which 19 were included in the review. Eleven studies reported primary research, and eight reported either narrative or systematic reviews. Seven main risk communication strategies were identified: framing, absolute versus relative risk, natural frequencies versus percentages, personalised risk estimates, qualitative risk communication, best-case/worst-case framework and use of graphs and graphics. There was a paucity of risk communication strategies specific to the CKD population. Evidence-based strategies to improve health risk communication for patients living with CKD are lacking. There is a need to establish the informational and communication preferences for patients living with CKD to better understand how to best communicate health risk information to individuals in this population.

Fighting fiscal awkwardness: How relationship strength changes individuals' communication approach when resolving interpersonal debt.

Social interactions can be uncomfortable. The current research focuses on a particularly uneasy interaction that individuals face with their friends and acquaintances: the need to request owed money back. Nine preregistered studies (N = 6,953) show that individuals' approach to resolving interpersonal debt varies based on their closeness with the requestee. Specifically, people prefer communication methods low in social richness (e.g., digital apps) when requesting money back from weak social connections such as distant acquaintances. However, they prefer communication methods high in social richness (e.g., in-person interactions) when requesting money back from strong social connections such as close friends. Process evidence reveals the psychological dynamics at play: (a) people anticipate discomfort when requesting money back from distant acquaintances in person, driving them away from in-person requests and toward digital apps, and (b) people are more averse to appearing impersonal with close friends, driving them away from digital apps and toward in-person requests. In sum, individuals adaptively approach uncomfortable financial interactions based on the relationship dynamics at hand. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

“I’d just love to hear what the community has to say”: Exploring the potential of community-driven vaccine messaging amongst ethnic minority communities

ABSTRACT Community-based communication interventions improve health outcomes and foster positive behavioral changes across diverse populations. However, their potential to support vaccine readiness remains underexplored. This paper addresses this gap by investigating the opinions and preferences of ethnic minority community members who attended a health information session regarding community-delivered vaccine messaging. The study explored the perceptions and willingness to engage in community-led communication efforts about vaccination, focusing on COVID-19 booster vaccines. In-depth interviews were conducted between November and December 2023 with individuals from ethnic minority communities in Central Eastern Sydney who attended an information session about COVID-19 boosters. Four key themes emerged from speaking to this specific group, highlighting diverse communication preferences and intentions. Participants emphasized obtaining vaccine-related knowledge from various sources, particularly through interpersonal discussions. Trusted voices like general practitioners (GPs) and targeted media campaigns were deemed to be crucial. Recommendations included leveraging community champions and establishing a central body for efficient vaccination campaign management in multicultural communities. Personal engagement through community discussions was stressed, with inclusive spaces recommended in various settings. Effective strategies include transparent communication, credible health professional endorsement, and addressing concerns with balanced responses. The findings accentuate the potential effectiveness of grassroots, community-centric initiatives in promoting informed vaccine messaging, countering misinformation, and engaging communities in meaningful health dialogs. Further research on tailored communication and strategic partnerships could enhance this initiative and promote sustained health literacy within ethnic minority communities.

Men’s Preferences for Language and Communication in Mental Health Promotion: A Qualitative Study

Tailored language and communication strategies underpin men’s engagement with public health initiatives. The aim of this study was to explore men’s preferences for language and communication in mental health promotion and provide recommendations for current and future programs. A sequential mixed-methods design was used including five focus groups and 21 individual interviews with 64 men. Interpretive description was used to inductively derive three themes: (1) Using coded language to confer mental health, which highlighted the tacit meaning and implications of language as well as men’s covert strategies to communicate their challenges and emotions; (2) Summoning masculine capital with association and metaphors, wherein men’s strategies for conveying mental health in acceptable and relatable ways are chronicled; and (3) Dynamism language to signal action and growth, illustrating participants’ preference for strength-based approaches and gain-framed messaging that positions men as drivers of self-management and personal development. Important implications for men’s mental health promotion are discussed.

Preferences regarding the Booster Dose of Covid-19: a cross-sectional study in Central Italy

Abstract Background Examining information sources, communication channels, and preferred content formats is crucial for adapting and improving future communication strategies in vaccination campaigns. This study aims to evaluate the information and communication preferences regarding the booster dose of Covid-19 among employees of the Central Tuscany Local Health Authority (CT-LHA). Methods From July to October 2022, a questionnaire was administered to 7,000 out of approximately 15,000 CT-LHA employees. The questionnaire analyzed communication, organizational, and access aspects regarding preferences for the Covid-19 booster dose. The sample was stratified into healthcare workers (HCWs) and non-healthcare workers (NHCWs). Chi-squared tests were performed using STATA, with the significance level set at 95%. Results The returned questionnaires were 1,885 (26.9%), with the majority being HCWs (64.4%). HCWs rated the quality of communication significantly lower compared to NHCWs, who rated it very high (p < 0.05). HCWs also rated the ease of booking the Covid-19 booster dose and access modalities to vaccination significantly lower than NHCWs (p < 0.05). NHCWs expressed a preference for receiving scientific information from Ministry of Health tutorials, while HCWs preferred information from their general practitioner (p < 0.05). HCWs preferred to receive organizational information from healthcare management, while NHCWs preferred information from vaccination physicians (p < 0.05). Additionally, HCWs preferred company operating procedures for disseminating information, whereas NHCWs preferred corporate communications circulars (p < 0.05). Conclusions HCWs and NHCWs showed differences in perceived quality of communication, ease of access to vaccination services, and preferred sources of information. HCWs rated the quality of communication and access to vaccination services lower than NHCWs. This results suggest the need for tailored communication strategies to effectively reach both groups. Key messages • Health organizations need to develop targeted communication approaches that address the specific needs and preferences of their employees. • Flexibility and adaptability are crucial to adapt communication methods and channels to strengthen vaccination initiatives and promote public health outcomes.

Cervical Cancer Screening: Patient Perspectives on Transitioning to Primary High-Risk Human Papillomavirus Testing Alone.

In 2018, the US Preventive Services Task Force updated cervical cancer screening recommendations to allow for screening every 5 years with primary human papillomavirus (HPV) testing in combination with cytology (cotesting) or every 5 years with primary HPV screening alone. Despite these changes, the uptake of primary HPV screening has been lower than expected. The purpose of this study was to evaluate the patient perspective of an integrated health system transition from cotesting to primary HPV testing among a 30- to 65-year-old cohort. Semistructured phone interviews were conducted from July to December 2023 at Kaiser Permanente Colorado with 16 members aged 30-65 years. Interviews asked about reactions to the forthcoming change in cervical cancer screening, personal concern about cervical cancer risk, feedback on patient-facing education materials, and preference on communication timing and modality. Participants reported concerns about cervical cancer screening intervals, primarily the reduction in frequency leading to underdiagnosis of sexually transmitted infections (STIs). Participants recommended defining the rationale for the change to primary HPV testing in the patient education materials. Participants preferred communication about the change in-clinic between practitioner and patient. The interviews identified key themes, including the differentiation between cervical cancer and STI screening methodologies, potential underdiagnosis of STI and cervical cancer, and the rationale supporting primary HPV testing and associated screening intervals. These qualitative findings can inform health systems of potential patient concerns to address when considering the transition from cotesting every 3 years to primary HPV testing every 5 years for cervical cancer screening.

NICU Caregiver Communication Preferences and Disparities by Primary Language: A Qualitative Study.

Effective communication between clinical providers and infant caregivers is vital to family-centered care and engagement in the NICU. Infants in the level IV NICU often have complex medical needs and prolonged lengths of stay, leading to challenges maintaining effective and consistent communication, particularly for families with a primary language other than English. The objective of this qualitative study is to determine the facilitators and barriers to effective communication among English- and Spanish-speaking caregivers in a level IV NICU. This phenomenology qualitative study consisted of interviews with English- or Spanish-speaking caregivers of infants admitted to a single-site level IV NICU for at least 7 days. Interviews were conducted using a semistructured interview guide that sought to understand the lived experience of parents communicating with providers. Themes from coded interview transcripts were identified using inductive thematic analysis. Nineteen interviews were completed in participants' primary language (English or Spanish), and 5 themes emerged from the analysis. For English- and Spanish-speaking caregivers, we discovered the importance of personal connection, the desire for receiving communication about changes directly from providers, and a strong desire for daily updates. For Spanish-speaking families, we found disparities in the use of communication-related technology and consistent communication from providers in their primary language. In this qualitative study, we identified caregiver preferences for communication from providers in a level IV NICU and demonstrated disparate experiences for Spanish-speaking caregivers. Future work should focus on developing interventions that address these identified barriers to communication.

Attitudes, healthcare interactions, and communication preferences for HPV vaccines among hesitant Hispanic/Latinx parents: how does this compare with influenza and COVID-19 vaccines?

ABSTRACT Objective We explored HPV vaccine concerns and healthcare provider communication among Hispanic/Latinx hesitant parents during the COVID-19 pandemic, and how those concerns and provider communications compared for influenza and COVID-19 vaccines. As a secondary aim, we explored communication needs and strategies for these recommended vaccines. Design We applied a concurrent, multi-method study design (survey and interview) with 23 Hispanic/Latinx American parents of adolescents aged 11–18 years. An inductive deductive thematic approach was used to interpret interview data. Descriptives were used to analyze survey data. Results Overall, most parents (77%) perceived that their child was receiving too many vaccines. Regarding hesitancy for the HPV vaccine, major parental concerns related to vaccine effectiveness (83%), vaccine necessity (83%), and vaccine safety (80%). For the COVID vaccine, major concerns were the newness of vaccine (83%), vaccine safety (77%), low perceived effectiveness (77%), and low perceived need (77%). For influenza vaccines, major parental concerns were vaccine safety (73%), low perceived need (73%), and preference for natural over vaccine-induced immunity (73%). Parents had overall positive views towards vaccination. Some parents prioritized school-required vaccines, and others ranked the recommended vaccines- HPV, COVID-19, and influenza vaccines- for their children. They saw the benefits of recommended vaccines; however, there were concerns. The majority received a provider’s recommendation for HPV vaccination for their child, while over half had not received a recommendation for COVID-19 and influenza vaccines. Recommended communication strategies were diverse with parents highlighting the need for providers to capitalize on waiting and clinic rooms to provide education. Conclusion Healthcare providers should take advantage of missed opportunities, improve healthcare interactions with a strong recommendation and persistent communication, and offer diverse communication strategies and messaging for vaccines. Future work should further explore multi-vaccine concerns and how addressing these concerns through healthcare-provider communication could improve HPV vaccination along with COVID-19 and influenza vaccination.

Communicating about COVID-19 Vaccines: A Qualitative Study on Preferences, attitudes, and Influences on Canadian Post-secondary Student Decisions to Get Vaccinated

Given the reasonably low COVID-19 vaccine rates (e.g., <60% fully vaccinated) among Canadian young adults (18–29), we sought to understand the factors that motivated this demographic to get vaccinated. Fifteen post-secondary students and graduates participated in semi-structured interviews about the type of health information they received during the pandemic, and their communication preferences. Analysis of interview data revealed four themes: (1) Participants had high science and health literacy which equipped them to identify and dismiss misinformation; (2) Participants expressed high trust in official sources which positively impacted their confidence in the vaccines; (3) Participants exhibited a low perceived risk from COVID-19 infection and got vaccinated for reasons beyond personal protection; and, (4) Participants responded best to communication that was targeted and tailored towards them. These themes form a foundation for effective vaccine communication campaigns targeted and tailored toward young adults, which is essential for acceptance of future vaccine recommendations.

Illness-related communication between siblings and parents of children with chronic illness and life-limiting conditions: A qualitative analysis.

Having a brother or sister who has a chronic illness (lasting >6 months and requiring long-term care) or life-limiting condition (LLC; where cure is highly unlikely and the child is expected to die) has major impacts on siblings. Parent-sibling illness-related communication may contribute to siblings' capacity to cope. In this study, we aimed to explore parent-sibling illness-related communication, from the perspectives of parents and siblings. We also aimed to qualitatively compare participants' responses according to illness group (chronic illness vs. LLCs). We collected qualitative data from siblings (32 with a brother/sister with a chronic illness, 37 with a brother/sister with an LLC) and parents of a child with a chronic illness (n = 86) or LLC (n = 38) using purpose-designed, open-ended survey questions regarding illness-related communication. We used an inductive qualitative content analysis and matrix coding to explore themes and compare across illness groups. Two-thirds of siblings expressed satisfaction with their family's illness-related communication. Siblings typically reported satisfaction with communication when it was open and age-appropriate, and reported dissatisfaction when information was withheld or they felt overwhelmed with more information than they could manage. Parents generally favored an open communication style with the siblings, though this was more common among parents of children with an LLC than chronic illness. Our findings show that while many siblings shared that they felt satisfied with familial illness-related communication, parents should enquire with the siblings about their communication preferences in order to tailor illness-related information to the child's maturity level, distress, and age.

Understanding the factors that impact federal rulemaking: a survey of former EPA regulators.

While federal rulemaking is an essential part of American governance, it is not well understood by researchers and advocates. We surveyed 115 former regulators at the Environmental Protection Agency to understand their views on the kinds of information they valued most and their communication preferences (June-August 2023). Respondents highly valued information about the scope of a problem (96%), legal analysis (97%), technology assessments (96%), and impacts of a proposed rule (99%). Regulators had difficulty accessing several kinds of information: 16% of respondents viewed racial equity information as easy to access and 30% thought financial information was easy to access. Respondents valued communications that provided data (99% viewed as effective), made compelling arguments (97%) or technical recommendations (93%), and storytelling (88%). Respondents indicated that the content of comment letters was important: 94% viewed letters containing data as important and 90% valued technical recommendations. Only 22% thought that repetition of the same comments across letters was important. Our findings reveal opportunities for researchers and advocates to help fill information gaps and identify communication strategies that might resonate with federal regulators.

The Use of English Relative Clauses by Indonesian Authors: A Case Study in Business, Engineering, and Science Journal Articles

The ability to effectively use relative clauses is pivotal in English journal articles, as it allows authors the flexibility to modify various noun phrases within sentences to convey clearer and more precise writing. This research explores the strategies employed by Indonesian authors from three distinct disciplines - business, engineering, and science. To accomplish this, we analyzed thirty papers published in Electrical Engineering and Computer Science, Makara Journal of Science, and Gadjahmada International Journal of Business. In total, 1453 relative clauses were collected and analyzed. A cross-classification analysis was performed to examine the distribution of relative clauses. The findings of the study indicate a preference among Indonesian writers to use non-reduced relative clauses, specifically those that serve as restrictive modifiers for objects. We also observe that the past participle is employed with greater frequency than the present participle. The results reveal that Indonesian authors prefer non-reduced relative clauses over reduced ones, opt for restrictive clauses over non-restrictive ones, and consistently favor relativizing the subject (S-form) in their relative clauses over the object (O-form). Our results also show that the choice of relative clauses is subject-specific, influenced by the distinct communicative requirements and preferences within each field. Our examination of relative clauses has provided insights into the syntactic choices, including their reduction status, restrictiveness, the use of participles, connectors, and the syntactic category modified by the clause.

Impact of a care delivery intervention for patients with socioeconomic disadvantages, in their preferred language of English or Spanish.

97 Background: Sinai Health System’s oncology program serves Chicago’s inner city patients with substantial needs for social and primary care, many of whom prefer communication in Spanish. Sinai has implemented a care delivery intervention to address these needs, using the 4R Oncology Model for patient-facing care planning and patient self-management. 4R (Right Info/Care/Patient/Time) has shown significant improvements in the timeliness of care cancer delivery and referrals to cancer care (1). Herein, we implemented the 4R intervention to improve the timeliness of care delivery and referrals to care, focusing on the social and primary care needs of Sinai patients. Methods: Evaluation was conducted by surveying historical control and intervention (4R) cohorts of patients in their preferred language of Spanish or English. The 4R cohort received care at a Sinai medical oncology clinic Apr 2023 - Jan 2024. Control cohort received care Jan 2023 – March 2023. Analyses were conducted using Fisher’s exact test. Results: Survey response rates: 76% (38/50) in control and 75% (33/44) in 4R cohorts. Participant characteristics were comparable between control and 4R cohorts, respectively: 55%, 58% Hispanic, 42%, 39% Black; 76%, 82% high school education or less; 87%, 97% < 30k income; 50%, 55% preferred language Spanish; 47%, 45% English. For the total cohorts, all 5 metrics improved between control and 4R, and 4 of the 5 metrics improved significantly (Table). Among Spanish-preferred patients, 3 of the 5 metrics improved significantly, while improvements among English-preferred patients were not statistically significant. Both language groups saw numerical, but not statistically significant improvement in receiving referrals to primary care and meeting all their practical and family needs. Conclusions: The 4R Oncology intervention resulted in significant improvement in time to treatment and referrals to social and primary care in our population of socioeconomically disadvantaged patients with high needs for these services. Patients preferring Spanish benefited at a higher rate than English-preferring patients, indicating that 4R may be an effective method to address the needs of this important patient group. Future efforts will further optimize 4R to address remaining gaps for this group, as well as to improve the delivery of this care for the English-preferred patients. 1. Trosman JCO OP 2021. Metric Control Total %N=38 4R Total %N=33 Control Spanish %n=19 4R Spanish %n=18 Control English %n=19 4R English %n=15 Started treatment within 6 weeks of diagnosis 61 88* 53 94* 68 80 Received referral to primary care 66 82* 74 83 58 80 Received referral to support for transportation, food, and other needs 68 85* 63 89* 74 80 Referred to help and resources to help pay for care 50 67* 47 78* 53 53 All of my practical and family needs were addressed 86 89 84 89 87 87 *p<0.1 comparing control and 4R cohorts.

Telehealth use and acceptability amongst a diverse oncology patient population.

104 Background: Existing research describes numerous barriers to care for patients with cancer, including time constraints, cost, and additional health conditions. We sought to assess telehealth access and experience amongst a diverse patient population at an academic medical center. Methods: We administered a 60-question, cross-sectional, in-person survey to adult patients with a diagnosis of solid tumor or hematological malignancy on active treatment at Columbia University Irving Medical Center (CUIMC) in New York, NY between January 2023 and February 2024. The survey assessed access to and attitudes, beliefs and experience with telehealth as part of routine care and clinical trials. Demographics including age, gender, race/ethnicity, marital status, income, insurance type and education were self-reported. Results: The survey was administered to 100 patients with cancer (breast cancer, n=25; gastrointestinal cancer, n=25; genitourinary cancer n=25; and hematologic malignancy, n=25); 37% were actively enrolled or previously enrolled on a clinical trial. The mean age was 61 years; 51% were female; 45% non-White, and 23% Hispanic. The majority (63%) reported traveling >30 min to their treatment, with 48% reporting travel costs >$20 per visit. Six percent reported difficulty receiving treatment due to cost, and 23% reported difficulty getting to visits due to other conditions or disabilities. The majority (87%) reported having access to a computer or electronic device; 99% of those had internet access and 81% were comfortable using the internet. Of those who had prior video visits (59%), almost all (97%) reported that video visits addressed their issues/questions well. About a quarter of the patients who had not had a video visit reported that they would prefer to have video visits about a cancer-related issue rather than going into the office. For those who preferred a video visit (n=18), top reasons included elimination of travel, convenience, and not feeling rushed. Top barriers among those who expressed hesitance (n=23) included lack of access to necessary technology, not knowing how to use the technology, concern about getting the same level of care, or preference for in-person communication. Similar to video visits, 52% participants reported that they had a scheduled telephone visit with their oncologist instead of going to the office; 98% reported that their issues were either somewhat or very well addressed. Conclusions: In this cross-sectional study amongst a racially, ethnically and socioeconomically diverse population, we found that most patients with cancer on active treatment had access to telehealth and were satisfied with telehealth visits. Those who had not utilized telehealth were interested given convenience and elimination of travel. We found minimal barriers to telehealth access in this diverse urban population. Telehealth may offer an adjunct to reduce financial and logistic barriers to cancer care.

Prospectively investigating the impact of AI on shared decision-making in post kidney transplant care (PRIMA-AI): protocol for a longitudinal qualitative study among patients, their support persons and treating physicians at a tertiary care centre

IntroductionAs healthcare is shifting from a paternalistic to a patient-centred approach, medical decision making becomes more collaborative involving patients, their support persons (SPs) and physicians. Implementing shared decision-making (SDM) into...