{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:03:15Z","timestamp":1790150595684,"version":"4.0.1"},"reference-count":66,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To understand patients' access to telehealth and broadband and interest in the\n                      <jats:italic>Affordable<\/jats:italic>\n                      Connectivity Program (ACP) in an urban, safety\u2010net setting, using community\u2010engaged iterative learning cycles to improve patient\u2010centered care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Study Setting<\/jats:title>\n                    <jats:p>Roots Community Health, a health center focused on uplifting those impacted by systemic inequities, functions as a community\u2010anchored learning health system (LHS). Community was engaged in data collection and intervention development through Roots' Telehealth Patient Advisory Council. A cross\u2010sectional survey was administered to adult patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Roots designed and implemented an intervention to connect patients to digital access resources, including a 66\u2010item questionnaire capturing patients' telehealth experience and barriers, device and broadband access, and awareness of ACP\u2014a federal benefit providing up to $30 monthly toward internet for low\u2010income households. Patients interested in ACP were offered enrollment support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection Methods<\/jats:title>\n                    <jats:p>Patients were screened for ACP interest and eligibility and offered survey participation, in\u2010person or by phone by trained clinic staff and volunteers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>One hundred nine patients were screened for ACP eligibility and interest; 99 completed the survey. Two\u2010thirds (65\/99) had experience with telehealth and 53% (52\/99) were interested in future telehealth appointments. Patients reported several notable barriers: slow internet (46\/98), no Internet access (40\/99), mobile data plan issues (31\/98), and downloading\/using the telehealth software (31\/98). Surveyed patients frequently reported utilizing the Internet for resources categorizable as Social Drivers of Health (SDOH). Most screened patients (65\/109) had not heard of ACP, but over half (60\/109) reported interest in applying.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using a community\u2010embedded LHS approach, we found that broadband connectivity is crucial for equitable telehealth access, an essential part of healthcare in clinics that aim to remedy persistent health inequities affecting people of African descent. Policy and advocacy should prioritize this SDOH, while healthcare organizations evaluate their role in broadband policy to improve equity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lrh2.70121","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:01:02Z","timestamp":1790035262000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Leveraging a Locally Anchored Learning Health Care System Toward Equitable Telehealth: Assessing Broadband Access and Supporting Use of Federal Internet Subsidies in a Safety\u2010Net Setting"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9169-763X","authenticated-orcid":false,"given":"Samantha M. R.","family":"Kling","sequence":"first","affiliation":[{"name":"Evaluation Science Unit, Division of Primary Care and Population Health, Department of Medicine, Stanford School of Medicine Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7884-3604","authenticated-orcid":false,"given":"Jonathan G.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Evaluation Science Unit, Division of Primary Care and Population Health, Department of Medicine, Stanford School of Medicine Stanford University  Stanford California USA"},{"name":"Community Partnership Program, Department of Medicine, Stanford School of Medicine Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9297-9345","authenticated-orcid":false,"given":"Aaron A.","family":"Tierney","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"},{"name":"Center for Applied Al, Sutter Health  Los Altos California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayra","family":"Reyes","sequence":"additional","affiliation":[{"name":"Roots Community Health  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2198-5147","authenticated-orcid":false,"given":"Kalijah","family":"Terilli","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford School of Medicine Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Mckinnon","sequence":"additional","affiliation":[{"name":"Roots Community Health  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noha","family":"Aboelata","sequence":"additional","affiliation":[{"name":"Roots Community Health  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6639-8484","authenticated-orcid":false,"given":"Temesgen","family":"Woldeyesus","sequence":"additional","affiliation":[{"name":"Roots Community Health  Oakland California USA"},{"name":"Department of Medicine, Stanford School of Medicine Stanford University  Stanford California USA"},{"name":"Division of Primary Care and Population Health, Department of Medicine, Stanford School of Medicine Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2115646"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.305784"},{"key":"e_1_2_10_4_1","unstructured":"Federal Communications Commission \u201cFCC Increases Broadband Speed Benchmark \u201d2024 cited March 12 2025 https:\/\/www.fcc.gov\/document\/fcc\u2010increases\u2010broadband\u2010speed\u2010benchmark."},{"key":"e_1_2_10_5_1","unstructured":"Federal Communications Commission \u201cConnect2Health Task Force . 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