Emily Jezewski

Telehealth allows older adults to take control over their health and preventive care; however, they are less likely to use telehealth. Minority older adults use telehealth services less than their White counterparts. During COVID-19, the U.S. Medicare system allowed for telehealth delivery of Annual Wellness Visits, which are known to improve use of preventive services. To increase telehealth use, we targeted vulnerable, low-income, minority older adults and provided education to improve knowledge of and identify barriers to telehealth use. Ultimately, this could serve as a means of improving health and preventive care services. Participants resided at independent living facilities, low-income housing, and elders of the Native American coalition; N = 257. Participants received written education materials; a subset attended a 20-min presentation. In this quasi-experimental study, participants completed a pre-post survey. Results were analyzed using Chi-Squared and Fisher’s Exact tests. Participants included 54 ‘in-person’ and 203 ‘at-home’ learners. Most were female (79%), single/widowed (51%), and white (65%). At baseline, 39% were familiar with telehealth; following education 73% stated understanding on accessing telehealth. Nearly 40% of participants said they would use telehealth in the future; a larger proportion of “in-person” (73%) learners were willing to use telehealth than “at-home” learners (41%) (p = 0.001). Divorced older adults and Blacks voiced greater likelihoods of using telehealth than their married/widowed and White counterparts, respectively (Χ2(3, N = 195) = 9.693, p = 0.02), (p = 0.01). This education program demonstrates an increase likelihood in health promotion among older adults by increasing confidence in accessing and future use of telehealth; therefore, we achieved our aim of promoting telehealth use and improving health promotion.

Background: Kidney transplant is the best treatment for end‐stage renal disease (ESRD); however, access is limited by severe organ shortage. Public Health Service increased risk donors (PHS‐IRD) represent a significant portion of available organs which are discarded at disproportional rates.Methods: Pediatric nephrologists were surveyed regarding PHS‐IRD kidneys to understand attitudes and perceived barriers to the use of these grafts in children. We sought to elucidate what methods may help increase the likelihood of PHS‐IRD acceptance.Results: Twenty‐two responses were received from United States pediatric nephrologists representing 11 UNOS regions (response rate 5.9%). Of respondents, 50% had been practicing for 20+ years, 77% in academic hospitals, and 63% in cities with over 1 000 000 people. All respondents worked in an institution with a kidney transplant program. 41% reported that they would not accept PHS‐IRD kidneys under any circumstance, 45% would accept depending on the candidate's medical status, and 14% routinely accepted PHS‐IRD kidneys. Infectious transmission was the biggest disincentive reported (59%), with only 55% of respondents feeling comfortable counseling families on the associated risks. 82% of respondents did not perceive all PHS‐IRD as the same, and 90% supported stratifying PHS‐IRD into tiers based on risk, which would increase the likelihood of organ acceptance (82%) and assist in counseling families (91%).Conclusions: With improved utilization, PHS‐IRD kidneys offer a step toward decreasing the organ shortage. These findings suggest hesitance in use of PHS‐IRD kidneys for pediatric recipients. Further stratification of risk could aid in provider organ acceptance and counseling patients.