Telehealth, Telebehavioral Health, and Patient Portal Willingness, Use, and Access Challenges among Migrant Farmworkers on H-2A Visas, North Carolina, USA, 2024

Abstract

Digital health services can facilitate patients’ access to healthcare. However, access to reliable internet and utilization of digital healthcare are patterned by race, ethnicity, and class in the United States. We assessed willingness, use, and challenges accessing digital healthcare platforms among farmworkers arriving in North Carolina on temporary H-2A work visas (n = 327). We fielded a survey on digital healthcare access in English and Spanish at a central arrival hub for H-2A visa holders in 2024. We calculated descriptive statistics and assessed associations between willingness to use and uptake of digital healthcare and demographic variables. Most participants were interested in utilizing telehealth and patient portals, but few had ever used these services. Among participants who had used telehealth, 50% reported needing assistance. Older participants were less likely to utilize patient portals than younger participants. Future interventions should consider the unique context of migrant farmworkers in building digital health service models and provide digital skills training.