title: Attitudes Toward Telemedicine in Urban, Rural, and Highly Rural Communities.
abstract: BACKGROUND
  The rate of telemedicine adoption using interactive video between patient and provider has not met expectations. Technology, regulations, and physician buy-in are cited reasons, but patient acceptance has not received much consideration. We examine attitudes regarding telemedicine to better understand the subjective definitions of its acceptability and utility that shape patients' willingness to use telemedicine.
  
  
  METHODS
  Using the Montana Health Matters study (a random, statewide survey [n=3,512]), we use latent class analysis to identify groups with similar patterns of attitudes toward telemedicine followed by multinomial logistic regression to estimate predictors of group membership.
  
  
  RESULTS
  Although only 5% are amenable to telemedicine regardless of circumstance, 23% would be comfortable if it could be convenient, whereas 29% would be situationally amenable but uncomfortable using telemedicine. Still, a substantial percentage (43%) is unequivocally averse to telemedicine despite the inconvenience of in-person visits. Educational attainment, prior Internet use, and rural residence are main predictors that increase the likelihood of being in an amenable group.
  
  
  CONCLUSIONS
  From the patient's perspective, the advantages of reduced travel and convenience are recognized, but questions remain about the equivalence to physician visits. Many people are averse to telemedicine, indicating a perceived incompatibility with patient needs. Only 1.7% of the respondents reported using telemedicine in the previous year; about half were veterans. Hence, few have used telemedicine, and key innovation adoption criteria-trialability and observability-are low. Increased attention to public awareness in the adoption process is needed to increase willingness to embrace telemedicine as a convenient way to obtain quality healthcare services.
authors.affiliation: 1 Department of Sociology, Brigham Young University , Provo, Utah.
authors.forename: Vaughn R A
authors.initials: VR
authors.lastname: Call
authors.affiliation: 1 Department of Sociology, Brigham Young University , Provo, Utah.
authors.forename: Lance D
authors.initials: LD
authors.lastname: Erickson
authors.affiliation: 2 Veterans Rural Health Resource Center-Western Region , VHA Office of Rural Health, Salt Lake City, Utah.
authors.forename: Nancy K
authors.initials: NK
authors.lastname: Dailey
authors.affiliation: 2 Veterans Rural Health Resource Center-Western Region , VHA Office of Rural Health, Salt Lake City, Utah.
authors.forename: Bret L
authors.initials: BL
authors.lastname: Hicken
authors.affiliation: 2 Veterans Rural Health Resource Center-Western Region , VHA Office of Rural Health, Salt Lake City, Utah.|4 Salt Lake VA Geriatrics Research Education and Clinical Center , Salt Lake City, Utah.
authors.forename: Randall
authors.initials: R
authors.lastname: Rupper
authors.affiliation: 3 School of Family Life, Brigham Young University , Provo, Utah.
authors.forename: Jeremy B
authors.initials: JB
authors.lastname: Yorgason
authors.affiliation: 2 Veterans Rural Health Resource Center-Western Region , VHA Office of Rural Health, Salt Lake City, Utah.
authors.forename: Byron
authors.initials: B
authors.lastname: Bair
mesh_terms: D001292:Attitude to Computers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009009:Montana; D012424:Rural Population; D017216:Telemedicine / Q000706:statistics & numerical data*; D014505:Urban Population
keywords: military medicine; policy; telehealth; telemedicine