title: Understanding the Knowledge Gap Experienced by U.S. Safety Net Patients in Teleretinal Screening.
abstract: Safety-net patients' socioeconomic barriers interact with limited digital and health literacies to produce a "knowledge gap" that impacts the delivery of healthcare via telehealth technologies. Six focus groups (2 African- American and 4 Latino) were conducted with patients who received teleretinal screening in a U.S. urban safety-net setting. Focus groups were analyzed using a modified grounded theory methodology. Findings indicate that patients' knowledge gap is primarily produced at three points during the delivery of care: (1) exacerbation of patients' pre-existing personal barriers in the clinical setting; (2) encounters with technology during screening; and (3) lack of follow up after the visit. This knowledge gap produces confusion, potentially limiting patients' perceptions of care and their ability to manage their own care. It may be ameliorated through delivery of patient education focused on both disease pathology and specific role of telehealth technologies in disease management.
authors.affiliation: Charles R. Drew University, Los Angeles, CA; UCLA, Los Angeles, CA.
authors.forename: Sheba M
authors.initials: SM
authors.lastname: George
authors.affiliation: L.A. Pierce College, Woodland Hills, CA.
authors.forename: Erin Moran
authors.initials: EM
authors.lastname: Hayes
authors.affiliation: Indiana University, Bloomington, Indiana.
authors.forename: Allison
authors.initials: A
authors.lastname: Fish
authors.affiliation: Los Angeles County Department of Health Services, Los Angeles, CA.
authors.forename: Lauren Patty
authors.initials: LP
authors.lastname: Daskivich
authors.affiliation: Charles R. Drew University, Los Angeles, CA; UCLA, Los Angeles, CA.
authors.forename: Omolola I
authors.initials: OI
authors.lastname: Ogunyemi
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D017144:Focus Groups; D057220:Health Literacy; D006297:Health Services Accessibility; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D017216:Telemedicine