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Wong and Co-authors Assess Care Quality by Telehealth Proportion in Veterans Health Administration Primary Care

In a recent publication in JAMA Network Open, CSDE Affiliate Edwin Wong (Health Services) and co-authors examined whether the proportion of primary care delivered via telehealth was associated with differences in care quality among 744,599 veterans in the Veterans Health Administration (VHA) between 2022 and 2023. Veterans with low or intermediate telehealth use had clinical and quality-of-care outcomes comparable to those receiving only in-person care across most measures, particularly cardiovascular and behavioral health measures. High telehealth users (those receiving 50% or more of their primary care remotely) had lower performance on outcomes that required or benefitted from in-person interaction, such as influenza vaccination, statin adherence, and depression screening. The findings support hybrid telehealth and in-person models while suggesting that high-proportion telehealth users may need additional resources to ensure quality care.

Marcotte Tests Chatbot Designs for Culturally Tailored Breast Cancer Screening Outreach

CSDE Affiliate Leah Marcotte (Medicine) and co-authors, in partnership with Cierra Sisters, recently published an article in Frontiers in Digital Health reporting on a randomized factorial experiment evaluating chatbot designs for breast cancer screening (BCS) outreach.  The study tested four conditions with a Black woman persona presented as either a primary care doctor or a breast cancer survivor who used either a direct versus polite communication styles. The doctor-polite condition was most preferred for trust and intention to use. Qualitative feedback indicated that the doctor persona and polite communication style were perceived as professional and friendly, respectively. While some participants appreciated representation in the use of a Black woman persona and found it relatable, others perceived it as stereotyping, patronizing, or targeting. Together this underscores the need for caution in culturally tailored chatbot design.