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Rural/Urban Differences in Clinical Care Task Learning (RP416)

Objectives Describe preferred learning modalities for clinical care task assistance among general adults and family caregivers. Report differences by rural/urban residence in learning modalities for clinical care task assistance among general adults and family caregivers. Importance. Rural family caregivers for patients with serious illness receive minimal formal training but often perform clinical care tasks far from clinical settings. Evidence-based strategies to prepare caregivers for these tasks are needed. Objective(s). We examined acceptability of clinical care task learning modalities among the general population and family caregivers. Method(s). Data from the population-based National Cancer Institute's 2018 Health Information National Trends were analyzed. Caregivers were those currently providing unpaid care/ making healthcare decisions for someone with a health condition. Main outcomes were learning modalities for clinical care tasks: in-person instruction, phone number/hotline, reading materials, online video instruction, or virtual (live instruction over the internet). Rural/urban residence was defined by Rural/Urban Commuting Area Codes: urbanĀ¼1-3, ruralĀ¼4-9. Multivariable logistic regression models predicting endorsement (yes/no) of learning modalities were regressed on rural/urban status for the general adult and caregiver populations. Models used sampling weights and adjusted for sociodemographics, and for the caregiver models included duration and hours/week caregiving and caregiver-patient relationship. Results. Analyses included 2847 adults (51% female, 64% White, 15% rural) and 378 caregivers (66% female, 66% White, 16% rural). In both the general and caregiver population, the most preferred modality for training was in-person (73%, 69% respectively) and the least endorsed were hotlines (13%, 18%). Rural general adult respondents reported 45% lower odds of preferring online/video instruction than urban respondents (adjusted OR: 0.55, 95% CI 0.39- 0.78). No other associations were significant in the general adult population and none were significant among caregivers. Conclusion(s). No differences in training preferences for clinical care task instruction between rural and urban family caregivers were found. However, among the general population, rural individuals were less likely to prefer online/video instruction. Impact. Future research to replicate these findings should be conducted to determine whether telehealth supportive care modalities are acceptable for rural populations.

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Journal of Pain and Symptom Management
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