(P143) INTERSECTIONALITY-BASED REVIEW OF HEART FAILURE TELEHEALTH/ REMOTE MONITORING INTERVENTIONS FOR VULNERABLE POPULATIONS

Background/Purpose: Telehealth/remote monitoring interventions have played a significant role in revolutionizing heart failure (HF) care, over the last two decades. Amidst the pandemic, telehealth programs have become an important mode of communication with clinicians, for HF patients. Given the unusual diversity of Canadian population, we also have a highly diverse HF patient population in Canada, which includes gender-diverse patients, patients from various ethnicities and races, patients having varying socioeconomic and immigration statuses, patients living in rural/ urban areas, and indigenous patients. In addition to singularly affecting the HF outcomes, each of these social identities also intersect with other factors, reinforcing the existing inequities in HF care. Yet, we have quite a generic version of HF telehealth/ remote monitoring programs that are offered to these unique and diverse groups of HF patients. Therefore, it is key to understand, to want extent intersectionality is incorporated while designing and implementing HF telehealth/ remote monitoring programs. The purpose of this review is to explore, to what extent intersectionality has been applied in designing, implementing, and evaluating HF telehealth interventions for vulnerable populations.

METHODS/RESULTS: For this intersectionality-based review of HF telehealth programs for vulnerable populations, literature was searched using the terms ‘Heart Failure’, and ‘telehealth OR remote monitoring’, with the relevant social identities, such as women/men, rural/sub-urban, Black, Hispanic, South Asian, Chinese, Caucasian/White, Gay/Lesbian/Transgender, immigrant/migrant/refugee, indigenous etc. Through the title, abstract, and full-text screening, those articles were included whereby HF telehealth programs would have been developed, implemented, or evaluated for vulnerable populations. Data was extracted using an intersectionality-informed checklist developed by Ghasemi et al. (2021). Based on screening, 27 studies were included. These studies have developed, implemented, or evaluated HF telehealth programs for ethnic minorities, rural communities, and low-income populations. Although all studies were done among vulnerable populations, the term ‘intersectionality’ has not been used in any of the studies. Aspects of intersectionality, such as, rurality and low socioeconomic status, or ethnicity and social class have been incorporated in some studies in patient recruitment, intervention implementation, or analysis. Intersections with biological sex and social aspects of gender have not been studied adequately.

CONCLUSION/IMPLICATIONS FOR PRACTICE: There are very few studies of HF telehealth that have been done among vulnerable populations; more studies incorporating intersectionality are required. Though some aspects of intersectionality have been utilized; however, HF telehealth research must incorporate intersectionality throughout, which can uncover important health inequities brought about by power disparities.