EP755 - Perceptions of Black Patients on Using Patient Engagement Technologies for Colorectal Surgery in Rural Alabama

Purpose/Background: Patient engagement technologies (PETs), which are applications or web-based platforms designed to guide patients during their healthcare journeys, have been associated with better postoperative outcomes, lower healthcare costs, and higher patient satisfaction. However, significant disparities in PET use exist, with patients who may benefit the most from PETs often being left behind, including Black patients and patients living in rural settings. As part of a larger study to develop a novel, tailored PET platform for rural Alabama, the objective of this study was to explore perceptions of Black patients on using PETs for colorectal surgery in rural Alabama.

Methods/Interventions: Black patients undergoing colorectal surgery who had not used a PET before were recruited from 2 rural hospitals in Alabama. Semi-structured interviews were conducted to explore perceptions on PET use for colorectal surgery. Transcripts were analyzed using inductive thematic and content analysis techniques. A constant comparative method was employed to ensure that data saturation was achieved.

Results/Outcomes: Overall, 14 participants were recruited and interviewed. Most patients were female (n=10) and mean age was 54.2 years. The most common procedure was colonoscopy. Three key themes emerged from the interviews: (i) major interest in using PETs, (ii) major benefits of PETs, and (iii) barriers to PET use (Figure 1). Most patients had not heard of PETs, but a few were familiar with and had used a patient portal or telehealth before. Most patients demonstrated a strong interest in using a PET if it was offered to them. Patients noted several benefits of using PETs including timely education about their health and procedures; a source of support and help for families; a reliable way of connecting with healthcare teams; a solution to reducing certain geographical barriers; and overall, promoting timely access to care. Patients also highlighted certain barriers to PET use. These included challenges of keeping up with and getting comfortable using the technology; need for resources including Wi-Fi; and relying on technical assistance, especially for certain age groups. Proposed solutions to these barriers included ensuring access to required resources; availability of technical support; and family / caregiver involvement. When specifically asked about barriers to PET use and quality care stemming from area of residence or race, a few patients emphasized they did not have access to the same modern technology as urban residents and that Black patients experienced disparities in access to quality care.

Conclusion/Discussion: Black patients residing and receiving colorectal surgical care in rural settings may have limited familiarity with PETs but have a strong interest in using them if offered. Several benefits of PET use were highlighted by patients who also noted certain barriers which need to be addressed. Insights gleaned from this study will help inform the development of a novel PET platform to improve colorectal surgical care in rural Alabama.

A Road Map to Patient Engagement Technology Use Among Black Patients Residing in Rural Settings