Determinants of telemedicine adoption for dementia care in underserved communities: Evidence from caregivers and healthcare professionals
Authors: Adedeji, A., Dogan, H., Adedoyin, F., Heward, M.
Journal: Health Policy and Technology
Publication Date: 23/06/2026
Volume: 15
Issue: 8
Publisher: Elsevier
eISSN: 2211-8845
ISSN: 2211-8837
Abstract:Background
: Telemedicine has the potential to improve access to dementia care in underserved communities, yet adoption remains limited in low-resource settings. Although caregiver burden, awareness of telemedicine, and digital literacy have been identified as potential determinants of technology uptake, their combined influence on telemedicine adoption in dementia care has not been sufficiently examined.
Objective
: This study examined whether caregiver burden, awareness of telemedicine, and digital literacy independently and jointly predict telemedicine adoption among family caregivers and healthcare professionals in underserved settings.
Methods
: A sequential explanatory mixed-methods design was used. Quantitative data were collected via a cross-sectional online survey of 441 participants, including 253 family caregivers and 188 healthcare professionals involved in dementia care. Measures assessed caregiver burden, awareness of telemedicine, digital literacy, and telemedicine adoption. Data were analysed using descriptive statistics, Pearson correlation, multiple linear regression, and analysis of variance. Qualitative data were obtained through semi-structured interviews with 25 participants and analysed using reflexive thematic analysis to explain the quantitative findings.
Results
: Digital literacy was the strongest positive predictor of telemedicine adoption, followed by awareness (both p < .001), while caregiver burden negatively predicted adoption (p < .001). Caregivers reported higher burden, whereas healthcare professionals showed greater awareness, digital literacy, and adoption. The model was significant (p < .001), explaining substantial variance. Qualitative findings highlighted caregiving strain, limited digital capability, infrastructural constraints, and dementia-related stigma as key influences.
Conclusions
: Telemedicine adoption in underserved dementia care contexts is influenced by interrelated individual and structural factors. Interventions that strengthen digital literacy and awareness while addressing caregiver burden may enhance uptake. These findings inform the design and implementation of context-sensitive telemedicine systems and support evidence-based decision-making in health policy and digital health implementation.
Public interest summary
: Dementia care in underserved communities is often provided by family members with limited access to specialist support. Telemedicine has the potential to improve access to care, but its use remains low in many low-resource settings. This study examined why telemedicine adoption remains limited by gathering evidence from family caregivers and healthcare professionals involved in dementia care. The findings show that people with stronger digital skills and greater awareness of telemedicine are more likely to use these services, while high caregiving burden makes adoption more difficult. Participants also highlighted challenges such as poor internet access, high data costs, and limited support for using digital tools. These findings highlight the need for policies and technologies that reduce caregiver strain, strengthen digital skills, and support equitable access to telemedicine services. Addressing these issues can help ensure that telemedicine benefits people living with dementia and their caregivers in underserved communities.
Source: Manual