Telehealth Utilisation Among Black Adults: A Cross-Sectional Study Using the 2022 Health Information National Trends Survey.

Background

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Aims

Telehealth has expanded access to health care, especially since the COVID-19 pandemic. However, disparities in telehealth use persist among racial and ethnic minorities, including Black adults, who face higher rates of chronic conditions such as diabetes and hypertension. Barriers such as limited digital health literacy, a preference for in-person care, and systemic inequities may hinder telehealth adoption in this population. Nurses play a vital role in assessing, educating, and advocating for patients navigating digital health platforms. This study assessed the prevalence of telehealth use among Black adults in the United States, identified key barriers and facilitators, and examined predictors of telehealth utilisation. Implications for nursing practice were explored to inform strategies for improving digital access and equity.

Method

We analysed data from the 2022 Health Information National Trends Survey (HINTS) using descriptive statistics to explore telehealth prevalence, barriers, and facilitators. Multivariate logistic regression identified predictors of telehealth use. Weighted analyses ensured nationally representative results.

Results

The analytic sample included 1,044 respondents, representing approximately 32 million Black adults after applying sample weights. Over the past 12 months, 36.5% (standard error [SE], 3.0) of Black adults used telehealth. Among those offered telehealth but opting out, 89.5% (SE, 4.4) preferred in-person care. Key facilitators included convenience (64.6%; SE, 4.6), avoiding hospital-acquired infections (52.0%; SE, 4.0), and provider recommendations (70.0%; SE, 4.0). Adults aged 31-45 years (adjusted odds ratio [aOR] 2.1; p=0.050) and 46-60 years (aOR 2.1; p=0.047) had higher odds of telehealth use than those aged 18-30 years. Black adults with cardiometabolic conditions were three times more likely to use telehealth than those without such conditions (aOR 3.0; p<0.001).

Conclusions

Telehealth use among Black adults is motivated by convenience and health concerns but hindered by a strong preference for in-person care. These findings underscore the need for culturally tailored, nurse-led interventions that address digital health literacy and patient engagement, particularly among those without existing chronic conditions. Nurses are uniquely positioned to assess readiness for telehealth, provide personalised education, and advocate for equitable access to digital care. Future nursing research should explore innovative telehealth models that centre patient preferences and reduce digital exclusion in underserved populations.