Abstract PO-006: Barriers to Virtual Video Connect (VVC) cancer care among southern rural veterans during the COVID19 pandemic
Authors: Haddad Philip A. , Hammoud Dalia , Phelan Michelle , Wallace-Seamster Rosline , Gallagher Kevin 
Published: December 2020

Abstract
Background: In response to COVID-19, the Department of Veterans Affairs (VA) adopted social distancing to slow the spread of the virus and minimize the risk of viral transmission to its high-risk patients. To help protect veterans and VA providers while ensuring that veterans continue to receive high-quality care, the VA embraced telehealth platforms such as VVC, where the provider conducts a real-time video visit through a secure connection to the patients’ computer, smart phone, or e-pad. While this platform is touted to be fast and easy, it still requires notable technical, skills, and knowledge components to be successful, which can be challenging in an older rural population. The Hematology-Oncology service of the Overton Brooks VA Medical Center embarked on a survey to explore the acceptability and the barriers to VVC care among our cancer patients.
Methodology: A phone survey of a random sample was conducted across five Hematology-Oncology clinics asking the veterans to consent for VVC visits and, if the veteran declined, to indicate the reason behind this decision. It specifically asked the veteran to categorize the reason as related to Equipment, Connectivity, Literacy, Privacy, Financial, or Other/Explain. Age, sex, and race characteristics were captured for each participant. Descriptive statistics and logistic regression were carried out.
Results: The sample consisted of 101 veterans from Arkansas, Texas, and Louisiana. The median age was 71 with the majority between ages 61-85 years. The participants were 96% male vs. 4% female and 45% Black vs. 55% White. Only 13% consented to VVC care. Among the veterans who declined, the reasons were related to lack of the appropriate equipment (53%), lack of adequate connection (14%), literacy (14%), and concerns with privacy (9%). No one cited financial issues. Among those who provided other reasons (10%), the majority did not see the advantage of VVC over a regular phone call. Except for “Other,” which consisted of 78% White, the rest of the categories’ racial breakdown mirrored the whole sample. Stepwise logistic regression revealed age (p=0.03) to be the only statistically significant factor that is inversely related to VVC acceptability.
Conclusion: These results confirm our experience that the older the veteran, the less the acceptability of VVC care. However, our survey indicates that 86% of the barriers to VVC use can be potentially overcome by providing the appropriate equipment along with education and training. Still, 14% of our veterans lack access to the internet. With appropriate funding and veteran training, VVC has the potential to play a major role in rural veteran cancer care during the COVID19 pandemic.
Citation Format: Philip A. Haddad, Dalia Hammoud, Michelle Phelan, Rosline Wallace-Seamster, Kevin Gallagher. Barriers to Virtual Video Connect (VVC) cancer care among southern rural veterans during the COVID19 pandemic [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-006.