{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T07:22:41Z","timestamp":1794295361097,"version":"4.9.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"AndyHill Care fund"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To examine the association between telehealth utilization and mammogram receipt by rurality, and to characterize geographic patterns of concurrent increases in telehealth and mammography use in urban and rural communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The sample included women, aged 50 years or older, receiving services in primary care or gynecology\/women\u2019s health practices at MultiCare Health System from 2018 to 2023. For the difference-in-difference (DiD) analyses, women who had only in-person visits during the prepandemic period but had at least one telehealth visit in each year of the postpandemic period were defined as the treatment group. Women who had only in-person visits during both pre- and postpandemic periods were defined as the control group. For the spatial analyses, we analyzed ZIP Codes in which both telehealth and mammography utilization increased from 2018\u20132019 to 2020\u20132022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>DiD analyses suggested that telehealth use was significantly associated with a greater probability of mammogram receipt among rural women; however, this association was not found in urban women. Spatial analyses indicated that concurrent increases in telehealth and mammogram use occurred in both rural and urban settings but exhibited greater spatial concentration in urban areas and comparatively more dispersed patterns across rural ZIP Code Tabulation Areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The findings suggest that telehealth may be particularly beneficial for improving mammography screening among rural individuals, who typically experience greater structural barriers to accessing health care. While urban areas may exhibit clustered patterns driven by interconnected care systems, rural areas may experience more diffuse but meaningful gains as telehealth expands access across large geographic distances.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996261460366","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:55:16Z","timestamp":1781157316000},"page":"985-993","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Telehealth and Mammogram Receipt in Urban and Rural Women: Quasi-Experimental and Spatial Analyses"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8595-8765","authenticated-orcid":false,"given":"Namrata","family":"Sanjeevi","sequence":"first","affiliation":[{"name":"Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Catherine","family":"Minnich","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Monsivais","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Robison","sequence":"additional","affiliation":[{"name":"Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaya Mangel","family":"Pflugeisen","sequence":"additional","affiliation":[{"name":"Institute for Research and Innovation, MultiCare Health System, Tacoma, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofer","family":"Amram","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Exercise Physiology, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_3_2_2_1","unstructured":"1.Health Resources & Services Administration. What is Telehealth? Available from: https:\/\/www.hrsa.gov\/telehealth\/what-is-telehealth [Last accessed: March 2022]."},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.37765\/ajmc.2025.89700"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.24294"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12609-022-00468-w"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.5534"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/life14060777"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2021.106741"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2020.106156"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djac217"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1443992"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10900-013-9681-1"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.19.00764"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.23970\/AHRQEPCCER256"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.63881"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2020.305579"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2025.103320"},{"key":"e_1_3_2_18_1","unstructured":"17.About MultiCare | MultiCare. Available from: https:\/\/www.multicare.org\/about-us\/ [Last accessed: May 2021]."},{"key":"e_1_3_2_19_1","unstructured":"18.FitchRatings. Fitch revises Multicare Health System WA\u2019s outlook to stable; Affirms ratings at \u201cA+\u201d. 2024. Available from: https:\/\/www.fitchratings.com\/research\/us-public-finance\/fitch-revises-multicare-health-system-wa-outlook-to-stable-affirms-ratings-at-a-18-09-2024 [Last accessed: May 2026]."},{"key":"e_1_3_2_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-023-07211-8"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229022"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqac141"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2004.042432"},{"key":"e_1_3_2_24_1","unstructured":"23.WWAMI Rural Health Research Center. Rural\u2013Urban Commuting Area (RUCA) codes. Available from: https:\/\/familymedicine.uw.edu\/rhrc\/ruca\/ [Last accessed: January 2026]."},{"key":"e_1_3_2_25_1","unstructured":"24.U.S. Census Bureau. ZIP Code Tabulation Areas (ZCTAs). Census.gov. 2023. Available from: https:\/\/www.census.gov\/programs-surveys\/geography\/guidance\/geo-areas\/zctas.html [Last accessed: January 2026]."},{"key":"e_1_3_2_26_1","unstructured":"25.R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing Vienna Austria. 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