{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T20:24:15Z","timestamp":1787689455311,"version":"build-2784847793"},"reference-count":89,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">As a result of the COVID-19 public health emergency (PHE), telehealth utilization accelerated to facilitate health care management and minimize risk. However, those with mental health conditions and substance use disorders (SUD)\u2014who represent a vulnerable population, and members of underrepresented minorities (e.g., rural, racial\/ethnic minorities, the elderly)\u2014may not benefit from telehealth equally.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">To evaluate health equality in clinical effectiveness and utilization measures associated with telehealth for clinical management of mental health disorders and SUD to identify emerging patterns for underrepresented groups stratified by race\/ethnicity, gender, age, rural status, insurance, sexual minorities, and social vulnerability.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">We performed a systematic review in PubMed, Embase, Cochrane Central Register of Controlled Trials, and CINAHL through November 2022. Studies included those with telehealth, COVID-19, health equity, and mental health or SUD treatment\/care concepts. Our outcomes included general clinical measures, mental health or SUD clinical measures, and operational measures.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Of the 2,740 studies screened, 25 met eligibility criteria. The majority of studies (<\/jats:italic>\n                      n\n                      <jats:italic toggle=\"yes\">\u2009=\u200920) evaluated telehealth for mental health conditions, while the remaining five studies evaluated telehealth for opioid use disorder\/dependence. The most common study outcomes were utilization measures (<\/jats:italic>\n                      n\n                      <jats:italic toggle=\"yes\">\u2009=\u200919) or demographic predictors of telehealth utilization (<\/jats:italic>\n                      n\n                      <jats:italic toggle=\"yes\">\u2009=\u20093). Groups that consistently demonstrated less telehealth utilization during the PHE included rural residents, older populations, and Black\/African American minorities.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">We observed evidence of inequities in telehealth utilization among several underrepresented groups. Future efforts should focus on measuring the contribution of utilization disparities on outcomes and strategies to mitigate disparities in implementation.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/tmj.2023.0588","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T12:03:53Z","timestamp":1705406633000},"page":"1205-1220","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["Telehealth Use and Health Equity for Mental Health and Substance Use Disorder During the COVID-19 Pandemic: A Systematic Review"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6419-3433","authenticated-orcid":false,"given":"J. Priyanka","family":"Vakkalanka","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA."},{"name":"Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khyathi","family":"Gadag","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Lavin","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Ternes","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA."},{"name":"Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather S.","family":"Healy","sequence":"additional","affiliation":[{"name":"Hardin Library for the Health Sciences, University of Iowa, Iowa City, Iowa, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A.S.","family":"Merchant","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wakina","family":"Scott","sequence":"additional","affiliation":[{"name":"Office for the Advancement of Telehealth, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney","family":"Wiggins","sequence":"additional","affiliation":[{"name":"Office for the Advancement of Telehealth, Health Resources and Services Administration, U.S. Department of Health and Human Services, Rockville, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia M.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy, University of Iowa College of Public Health, Iowa City, Iowa, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas M.","family":"Mohr","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA."},{"name":"Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA."},{"name":"Department of Anesthesia and Critical Care, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.101075"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.34147"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2021.08.023"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-012-9594-4"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.878706"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11469-020-00367-0"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcaa110"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1017\/ipm.2020.72"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638237.2020.1757052"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11150-020-09538-3"},{"key":"e_1_3_4_12_2","unstructured":"Panchal N Saunders H Rudowitz R et al. The Implications of COVID-19 for Mental Health and Substance Use. KFF; 2023. Available from: https:\/\/www.kff.org\/coronavirus-covid-19\/issue-brief\/the-implications-of-covid-19-for-mental-health-and-substance-use [Last accessed: November16 2023]."},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-020-01896-8"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-5890.12244"},{"key":"e_1_3_4_15_2","unstructured":"The Academy of Medical Sciences MQ : Transforming Mental Health. Survey Results: Understanding People's Concerns about the Mental Health Impacts of the COVID-19 Pandemic. The Academy of Medical Sciences; 2020. Available from: https:\/\/acmedsci.ac.uk\/file-download\/99436893 [Last accessed: January8 2024]."},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7034a3"},{"key":"e_1_3_4_17_2","unstructured":"National Institute on Drug Abuse. COVID-19 & Substance Use. NIH; 2023. Available from: https:\/\/nida.nih.gov\/research-topics\/comorbidity\/covid-19-substance-use. [Last accessed: November 16 2023]."},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7005a3"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12562"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2019378118"},{"key":"e_1_3_4_21_2","doi-asserted-by":"crossref","unstructured":"Mueller JT Merdjanoff AA. Mental Health in Rural America During COVID-19 and Beyond. In: COVID-19 Frontline Responders and Mental Health: A Playbook for Delivering Resilient Public Health Systems Post-Pandemic (Horney JA. ed.) Emerald Publishing Limited: Leeds England; 2023; pp. 119\u2013133.","DOI":"10.1108\/978-1-80262-115-020231009"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.15190\/d.2021.20"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2003539"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1733848"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.2196\/18810"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2020.03.008"},{"key":"e_1_3_4_27_2","unstructured":"Office for the Advancement of Telehealth Health Resources and Services Administration. What is Telehealth? HRSA; 2022. Available from: https:\/\/www.hrsa.gov\/telehealth\/what-is-telehealth [Last accessed: November16 2023]."},{"issue":"1","key":"e_1_3_4_28_2","first-page":"e1","article-title":"Telemedicine catches on: Changes in the utilization of telemedicine services during the COVID-19 pandemic","volume":"28","author":"Friedman AB","year":"2022","unstructured":"Friedman AB, , Gervasi S, , Song H, et al. Telemedicine catches on: Changes in the utilization of telemedicine services during the COVID-19 pandemic. Am J Manag Care, 2022; 28(1):e1\u2013e6.","journal-title":"Am J Manag Care"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.202100191"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/08901171221112488e"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13721-021-00300-y"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocaa078"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_3_4_34_2","unstructured":"Telehealth.HHS.gov. Research Articles and Papers. Telehealth.HHS.gov; 2023. Available from: https:\/\/telehealth.hhs.gov\/research-articles [Last accessed: November16 2023]."},{"key":"e_1_3_4_35_2","unstructured":"Rural Health Research Gateway. Rural Health Research Gateway. 2023. Available from: https:\/\/www.ruralhealthresearch.org [Last accessed: November16 2023]."},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.52.6.377"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/eip.13113"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2022.108920"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2022.2090822"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.2196\/33092"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2022.06.012"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsab077"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000895"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1002\/imhj.21958"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14098"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2022.0300"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1177\/21501319221091430"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.202100363"},{"key":"e_1_3_4_49_2","first-page":"S346","article-title":"Widening rural-urban divide in telehealth use during the COVID-19 pandemic: A national observation study of primary care delivery in the Veterans Health Administration","volume":"37","author":"Leung LB","year":"2022","unstructured":"Leung LB, , Yoo C, , Chu K. Widening rural-urban divide in telehealth use during the COVID-19 pandemic: A national observation study of primary care delivery in the Veterans Health Administration. J Gen Intern Med, 2022; 37:S346\u2013S347.","journal-title":"J Gen Intern Med"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-022-07594-2"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000704"},{"issue":"1","key":"e_1_3_4_52_2","first-page":"26","article-title":"Breaking down barriers: Young adult interest and use of telehealth for behavioral health services","volume":"105","author":"Rosenthal SR","year":"2022","unstructured":"Rosenthal SR, , Sonido PL, , Tobin AP, et al. Breaking down barriers: Young adult interest and use of telehealth for behavioral health services. R I Med J (2013), 2022; 105(1):26\u201331.","journal-title":"R I Med J (2013)"},{"key":"e_1_3_4_53_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-020-00497-9"},{"key":"e_1_3_4_54_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19116930"},{"key":"e_1_3_4_55_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-022-01334-2"},{"key":"e_1_3_4_56_2","doi-asserted-by":"publisher","DOI":"10.1111\/josh.13150"},{"key":"e_1_3_4_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2022.07.848"},{"key":"e_1_3_4_58_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2021.0549"},{"key":"e_1_3_4_59_2","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000985"},{"key":"e_1_3_4_60_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.36298"},{"key":"e_1_3_4_61_2","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12570"},{"key":"e_1_3_4_62_2","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001079"},{"key":"e_1_3_4_63_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.18487"},{"key":"e_1_3_4_64_2","doi-asserted-by":"publisher","DOI":"10.1080\/09515070.2020.1791800"},{"key":"e_1_3_4_65_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2019.11.004"},{"key":"e_1_3_4_66_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.20177"},{"key":"e_1_3_4_67_2","doi-asserted-by":"publisher","DOI":"10.2196\/16309"},{"key":"e_1_3_4_68_2","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibab045"},{"key":"e_1_3_4_69_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-06969-1"},{"key":"e_1_3_4_70_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201900431"},{"key":"e_1_3_4_71_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-4956-6"},{"key":"e_1_3_4_72_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.19954"},{"key":"e_1_3_4_73_2","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12370"},{"key":"e_1_3_4_74_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2018.0227"},{"key":"e_1_3_4_75_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2019-212623"},{"key":"e_1_3_4_76_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2022.06.053"},{"key":"e_1_3_4_77_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2022.0436"},{"key":"e_1_3_4_78_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03403782"},{"key":"e_1_3_4_79_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40501-020-00210-2"},{"key":"e_1_3_4_80_2","unstructured":"Heath S. DEA Okays Telehealth to Prescribe Opioids Amid COVID-19 Emergency. TechTarget Inc. Xtelligent Healthcare Media; 2020. Available from: https:\/\/mhealthintelligence.com\/news\/dea-okays-telehealth-to-prescribe-opioids-amid-covid-19-emergency [Last accessed: November16 2023]."},{"key":"e_1_3_4_81_2","unstructured":"Verma S. Early Impact of CMS Expansion of Medicare Telehealth During COVID-19. Health Affairs; 2020. Available from: https:\/\/www.healthaffairs.org\/content\/forefront\/early-impact-cms-expansion-medicare-telehealth-during-covid-19 [Last accessed: November16 2023]."},{"key":"e_1_3_4_82_2","unstructured":"Health Resources & Services Administration. Telehealth Policy Changes after the COVID-19 Public Health Emergency. HRSA; 2023. Available from: https:\/\/telehealth.hhs.gov\/providers\/telehealth-policy\/policy-changes-after-the-covid-19-public-health-emergency [Last accessed: November16 2023]."},{"key":"e_1_3_4_83_2","unstructured":"Koma W Cubanski J Neuman T. Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future. KFF; 2021. Available from: https:\/\/www.kff.org\/medicare\/issue-brief\/medicare-and-telehealth-coverage-and-use-during-the-covid-19-pandemic-and-options-for-the-future [Last accessed: November16 2023]."},{"key":"e_1_3_4_84_2","unstructured":"CFIR. Consolidated Framework for Implementation Research. Available from: https:\/\/cfirguide.org [Last accessed: January8 2024]."},{"key":"e_1_3_4_85_2","doi-asserted-by":"publisher","DOI":"10.1017\/cts.2020.42"},{"key":"e_1_3_4_86_2","doi-asserted-by":"publisher","DOI":"10.1080\/01612840.2018.1499157"},{"key":"e_1_3_4_87_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10020244"},{"key":"e_1_3_4_88_2","doi-asserted-by":"publisher","DOI":"10.1093\/jamiaopen\/ooz024"},{"key":"e_1_3_4_89_2","doi-asserted-by":"publisher","DOI":"10.2196\/11694"},{"key":"e_1_3_4_90_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610215000241"}],"container-title":["Telemedicine and e-Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/tmj.2023.0588","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/tmj.2023.0588","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/tmj.2023.0588","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:35:04Z","timestamp":1777588504000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/tmj.2023.0588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":89,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1089\/tmj.2023.0588"],"URL":"https:\/\/doi.org\/10.1089\/tmj.2023.0588","relation":{},"ISSN":["1530-5627","1556-3669"],"issn-type":[{"value":"1530-5627","type":"print"},{"value":"1556-3669","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]}}}