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Purpose <p>Remote monitoring programs offer many benefits in oncology, but whether these programs are equitably utilized is poorly understood. To address this vital issue, we assessed disparities by language in a multi-lingual, multi-modal program at a high-volume cancer center.</p> Methods <p>Patients were automatically enrolled in the remote monitoring program if they (1) were hospitalized for COVID-19 (“high-risk”) or (2) tested positive for COVID-19 and were symptomatic but not hospitalized (“low-risk”). All received daily remote symptom questionnaires for 14 days, and high-risk patients received remote-capable pulse oximeters.</p> Results <p>Of 2,225 patients, 91% preferred English. Among low-risk (<i>n</i> = 1,835), completion of 1 + questionnaires was 60% for English-language-preferred (ELP) vs. 39% for non-English-language-preferred (NELP). Among high-risk (<i>n</i> = 390), completion of 1 + questionnaires or device readings was 71% for ELP vs. 43% for NELP. Multivariable logistic regression models showed persistently lower participation odds for NELP vs. ELP in both low- (OR = 0.5, 95% CI: 0.34–0.73, <i>p</i> &lt; 0.001) and high-risk groups (OR = 0.4, 95% CI: 0.22–0.72, <i>p</i> = 0.002). Variations also emerged in high-risk NELP participation: 24% only used questionnaires, 9% only used devices, and 10% used both.</p> Conclusions <p>These findings have critical implications for effective remote monitoring: While multiple modes of data capture boosts participation compared to a single approach, greater efforts are yet needed to promote equitable participation and outcomes.</p> Clinical Relevance Statement <p>In this assessment of a large remote symptom monitoring program for cancer patients in a real-world setting, we found disparities in participation based on preferred language. Using multiple, complementary methods for data capture, such as multilingual questionnaires and devices with electronic and analog clinical flows, may help balance gaps from the use of a single approach; however, additional efforts are still needed to ensure equitable participation.</p>

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Mind the gap: disparities by preferred language in a novel, large-scale remote symptom monitoring program for cancer patients

  • 期刊论文

  • 发表日期：

    2026年1月3日

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  • Allison Lipitz-Snyderman,
  • Susan Chimonas,
  • Zoe Spiegelhoff,
  • Olga Strachna,
  • Charlie White,
  • Kenneth Seier,
  • Gilad Kuperman,
  • Jericho Garcia,
  • Bobby Daly,
  • Mark Robson,
  • Fernanda Polubriaginof

摘要

Purpose

Remote monitoring programs offer many benefits in oncology, but whether these programs are equitably utilized is poorly understood. To address this vital issue, we assessed disparities by language in a multi-lingual, multi-modal program at a high-volume cancer center.

Methods

Patients were automatically enrolled in the remote monitoring program if they (1) were hospitalized for COVID-19 (“high-risk”) or (2) tested positive for COVID-19 and were symptomatic but not hospitalized (“low-risk”). All received daily remote symptom questionnaires for 14 days, and high-risk patients received remote-capable pulse oximeters.

Results

Of 2,225 patients, 91% preferred English. Among low-risk (n = 1,835), completion of 1 + questionnaires was 60% for English-language-preferred (ELP) vs. 39% for non-English-language-preferred (NELP). Among high-risk (n = 390), completion of 1 + questionnaires or device readings was 71% for ELP vs. 43% for NELP. Multivariable logistic regression models showed persistently lower participation odds for NELP vs. ELP in both low- (OR = 0.5, 95% CI: 0.34–0.73, p < 0.001) and high-risk groups (OR = 0.4, 95% CI: 0.22–0.72, p = 0.002). Variations also emerged in high-risk NELP participation: 24% only used questionnaires, 9% only used devices, and 10% used both.

Conclusions

These findings have critical implications for effective remote monitoring: While multiple modes of data capture boosts participation compared to a single approach, greater efforts are yet needed to promote equitable participation and outcomes.

Clinical Relevance Statement

In this assessment of a large remote symptom monitoring program for cancer patients in a real-world setting, we found disparities in participation based on preferred language. Using multiple, complementary methods for data capture, such as multilingual questionnaires and devices with electronic and analog clinical flows, may help balance gaps from the use of a single approach; however, additional efforts are still needed to ensure equitable participation.