Evaluating Access to Cellphones for Telehealth Among People Experiencing Homelessness.

Abstract

Background: Telehealth has expanded access to health care services, yet its effectiveness relies heavily on access to communication technology, particularly cellphones. People experiencing homelessness (PEH) face significant barriers to technological access, which may limit their ability to engage in telehealth.

Materials and methods: This pilot study evaluated cellphone access and barriers to use for telehealth among sheltered and unsheltered PEH at free community clinics in Virginia Beach, Virginia, through an orally administered survey. Differences in the use of telehealth between government-issued cellphone users and nongovernment-issued cellphone users in this population were examined, as well as differences in perceived barriers to cellphone access and telehealth utilization between sheltered PEH and unsheltered PEH.

Results: Of the 74 participants, 53% reported being sheltered PEH and 47% were unsheltered. Of the sheltered PEH, 97% reported having a cellphone, whereas only 74% of the unsheltered PEH reported having one. Significant barriers to utilization included the cost of devices (p = 0.013), inability to charge phones (p = 0.048), and a lack of mobile data (p < 0.001). Nongovernment cellphone users were more likely to use their cellphones for audio-only telehealth than government cellphone users. The study findings provide insights but, given sample size, they cannot be generalized.

Conclusion: PEH may have access to a cellphone; however, utilization for telehealth may be limited due to cost and technological barriers, as well as prioritization of texting and phone calls to preserve data. Overcoming these barriers is crucial to making telehealth an equitable health care tool for PEH.