Power of aesthetic species on social media boosts wildlife conservation efforts, say experts

Internet sensation: The popularity of the caracal has helped conservation efforts

Taylor & Francis Group

 

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A young caracal peaks out from behind the fynbos near the famous coastal road of Boyes Drive, Cape Town, South Africa.

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Credit: Photo by Michael McSweeney

Facebook and Instagram can boost wildlife conservation efforts through public awareness and engagement, according to a study published in the peer-reviewed journal Environmental Communication.

The findings based on the caracal – a wild cat native to Africa with distinctive tufted ears – demonstrate how social media can harness support for the predators, which some farmers shoot and poison.   

Results show that the mammal’s similarity to a domestic feline has attracted thousands of followers to internet feeds about caracal conservation. The researchers suggest this online appeal is linked to the phenomenon where cat images, videos, and memes go viral.

They highlight how ‘charismatic’ smaller mammals such as the caracal can be used as a ‘flagship species’ to communicate the aims of scientific research in rapidly urbanizing areas.

“Using an aesthetic species such as the caracal is an effective way to capture public attention to communicate the importance of conserving urban wildlife,” say Drs Gabriella Leighton and Laurel Serieys from the University of Cape Town.

“These findings highlight the use of smaller carnivores as flagship conservation species for rapidly urbanizing areas.

“This paper contributes to our understanding of the various ways in which the public can participate in science. It shows how charismatic species can contribute to conservation and public awareness of biodiversity in urban areas.

“The research demonstrates how a public interest in urban ecology and the global phenomenon of ‘cats on the internet’…can be harnessed to leverage conservation action.”

Better public engagement is key to achieving conservation goals, especially in biodiversity hotspots. A range of species are both unique to these regions and endangered, and these threatened areas are increasingly urbanized and understudied.

Cape Town is located within a biodiversity hotspot and home to the caracal, an elusive mammal regarded as vermin by livestock farmers elsewhere in South Africa.

The Urban Caracal Project (UCP) was set up in December 2014 to explore caracal ecology and social media was used to influence awareness and perceptions towards caracal conservation in an urban setting. The UCP is run by a research team hosted by the Institute for Communities and Wildlife in Africa at the University of Cape Town.

The project communicates its works in several ways including via a website but most interactions are via social media.

The study authors used Google Trends to assess the global popularity of caracals from 2004 to present day, before and after UCP was set up. They compared the interest with that in a similar African wildcat – the serval.

They also used recent Facebook and Instagram data to analyze all material UCP had posted online and looked at direct public engagement such as reported caracal sightings, rescues, and finds of the wildcats dead.

Results showed a doubling in search interest in the term ‘caracal’ since UCP was launched. This represents a 91% increase compared to that for ‘servals’ which rose by 76% in the same period. The authors say this suggests the project has helped raise awareness of the caracal as a species worldwide.

Other findings include the fact the project now has more than 16,800 Facebook followers and more than 7,300 on Instagram, figures that represent ‘micro-influencer’ status. Most are from people in South Africa but also include those in the UK, India, and the US.

The UCP has received traffic and interactions from accounts linked to the ‘Big Floppa’ meme inspired by an overweight caracal born in a cattery in Kyiv, Ukraine. Again, this links to the popularity of 'cats on the internet’ according to the authors.

The authors also say caracal deaths reported by the public – often via WhatsApp and social media – allow them to perform post-mortems. They can then assess threats to the caracal population and roadkill patterns.

Tissue analysis has revealed the animals are exposed to pollutants and pesticides, such as rat poison. Samples have even been collected from otherwise unreachable areas thanks to this citizen network.

The sightings and Facebook comments provide conservationists with useful information on how caracals respond to humans. Most encounters occur on roads or paths with caracals described as ‘chilled’ or ‘calm’ before quickly moving away.

The most common positive adjective used in Facebook comments is ‘beautiful’, and ‘sad’ for negative posts usually in response to a death or population threat. This demonstrates the extent to which social media engagement has led to people caring about caracal welfare, add the authors.

A caracal pauses on the steps of a garden of an urban edge property in Smitswinkel on the Cape Peninsula, South Africa.

Credit

Photo by Anya Adendorff

2018 03 pipe track IMG_9705_Ia [VIDEO] 

An adult caracal crosses a popular Table Mountain trail, the Pipe Track, to the delight of hikers.  

Credit   Video by Ian Merrington

2020-01-13 00.18.29 cape point [VIDEO] 

A mother caracal and her kitten move through the long grass of the Cape Point section of the Table Mountain National Park.

Credit  Video by Katrin Baier

2020-09-05 10.28.48 road cross [VIDEO] 

A caracal tagged by the Urban Caracal Project crosses the busy Kloof Road, which loops around Cape Town's famous Lion's Head peak.

Credit  Video by Anna Saifutdinova

A shy caracal looks out from behind some bushes near Miller's Point in the southern section of the Cape Peninsula, South Africa.

Credit

Photo by John Hishin

Two caracals pause in the fynbos vegetation of the Cape Point reserve in the southern part of the Cape Peninsula, South Africa.

Credit

Photo by Gilbert Reinhardt

Journal

Environmental Communication

DOI

10.1080/17524032.2024.2402466 

Article Title

Wild cats on the Internet: the role of social media in popularising caracals in South Africa

Article Publication Date

7-Nov-2024

 

New study maps dramatic 100-million-year explosion in color signals used by animals

University of Arizona

 

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The nonvenomous Arizona mountain kingsnake, which resembles a venomous coral snake, has a survival advantage by warning off would-be predators that avoid colorful coral snakes.

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Credit: John J. Wiens

Colors are widely used in communication within and among animal species. For example, peacocks proudly display their vibrant tails, adorned with iridescent eyespots, to attract peahens for courtship. This is a classic example of sexual selection using color signaling. Conspicuous colors are also displayed by toxic animal species, including many venomous snakes and the brilliantly colored poison frogs of Central and South America, as a warning to potential predators. 

A recent study by University of Arizona researchers analyzed the evolutionary timeline of color vision in animals and the different functions of "conspicuous colors" in animals and plants. Conspicuous colors include colors like red, yellow, orange, blue and purple, which stand out against most backgrounds. 

Based on statistical analysis, the study found that color vision evolved in animals more than 100 million years before the emergence of colorful fruits and flowers. The study, led by John J. Wiens, professor in U of A Department of Ecology and Evolutionary Ecology, is published in the journal Biological Reviews. 

The study focuses on two different types of color signals that animals use – warning and sexual.  It also analyzes the color signals that plants use for flowers and fruits. 

In plants, conspicuous colors have two main functions, Wiens said: for fruits, to disperse the seeds; for flowers, to distribute pollen. 

"We wanted to know when bright coloration evolved and what was the purpose of that coloration. That's largely why we pursued this study," said Zachary Emberts, study co-author and an assistant professor of integrative biology at Oklahoma State University. Emberts was a postdoctoral scholar at the U of A when the study was conducted.

Color vision in animals evolved about 500 million years ago, while colorful fruits appeared around 350 million years ago and colorful flowers about 200 million years ago, Wiens said. 

Weins said warning color signals emerged before sexual color signals – around 150 million years ago. Sexual color signals emerged about 100 million years ago. 

"There has been a dramatic explosion of both warning and sexual color signals in the last 100 million years," Wiens said. 

This is despite the fact that color vision evolved about 400 million years earlier. The exact reason behind the explosion is unknown. But the research team identified three key groups that likely drove the explosion in warning signals: ray-finned fishes in marine environments, and birds and lizards on land. 

Wiens said warning color signals are much more widespread among animals than sexual signals, which are confined to arthropods and vertebrates. 

"Warning signals are at least five times more widespread. That's the overall pattern," Wiens said. 

Warning color signals may be so widespread because the colorful animal doesn't need to have color vision itself in order to signal other animals of danger. In fact, species with warning color signals don't even need well-developed eyes. 

But when it comes to sexual color signals, males and females need to have advanced vision to signal each other using color cues. That is why sexual signals are exhibited only in two groups of animals that have eyes: vertebrates, which include fish, amphibians, mammals, birds and reptiles, and arthropods, such as insects and spiders. 

"In the future, it would be even more interesting to study what drives the ability of animals to see specific colors like red or blue," Emberts said.

The strawberry poison-dart frog exhibits vivid colors that serve as a powerful warning signal to predators.

Credit

John J. Wiens

Journal

Biological Reviews

DOI

10.1111/brv.13141 

Method of Research

Data/statistical analysis

Subject of Research

Animals

Article Title

How life became colourful: colour vision, aposematism, sexual selection, flowers, and fruits

 

Why health and price, not sustainability, drive US meat consumption choices

Health and taste were rated as the most important considerations when purchasing meat overall

Rutgers University

Environmental sustainability isn’t a major factor influencing meat consumption decisions for most Americans, despite increasing awareness of the climate impacts of red meat production, according to Rutgers researchers.

 

The study, published in Appetite, examined meat and seafood consumption patterns among a nationally representative sample of more than 1,200 U.S. adults. Researchers found while many Americans report reducing their red meat intake, health concerns and price are the primary motivators rather than environmental considerations.

 

“There's a disconnect between the mounting evidence on meat's environmental footprint and what's actually driving consumer behavior,” said Shauna Downs, an associate professor in the Department of Health Behavior, Society and Policy at Rutgers School of Public Health and lead author of the study. “Our findings suggest that messaging focused solely on sustainability may not resonate with most U.S. consumers regarding meat choices.”

 

Key findings from the study include:

• 78% of participants reported consuming red meat 1 to 4 times per week, with 14% consuming it 5 or more times weekly
• Nearly 70% said they had reduced red meat consumption in the past year, primarily citing health (64%) and price (32%) as reasons
• Six percent of those reducing red meat cited environmental sustainability as a factor
• Health (85%) and taste (84%) were rated as the most important considerations when purchasing meat overall
• Environmental sustainability (29%) and animal welfare (28%) were rated as least important

 

The researchers found some demographic differences in meat consumption patterns and motivations. For example, respondents ages 65 and older were more likely to report reducing red meat intake than younger adults. Black respondents rated factors such as price, health and sustainability as more important in meat purchasing decisions compared with other racial and ethnic groups. Compared to male respondents, female respondents reported environmental sustainability and health as important in making meat purchasing decisions.

 

“These findings can help inform more effective interventions and messaging campaigns to shift diets in a more sustainable direction,” Downs said. “Focusing on health benefits and affordability, rather than environmental impacts alone, is more likely to motivate changes in meat consumption for most Americans.”

 

The study comes as climate scientists increasingly point to reducing meat consumption, particularly beef and lamb, as a key strategy for mitigating climate change. However, efforts to reduce meat intake in the U.S. face cultural and political roadblocks, such as the strong lobbying power of the meat industry, with previous attempts to incorporate sustainability considerations into federal dietary guidelines being met with pushback.

 

“There are clearly some barriers to overcome in terms of making sustainability a priority for consumers,” said Emily V. Merchant, assistant professor in the Department of Urban-Global Public Health at the Rutgers School of Public Health and a co-author of the study. “Creative, multifaceted approaches that also emphasize health, taste and affordability may be needed to shift eating patterns in a meaningful way.”

 

The researchers said future studies should explore how to effectively combine different motivators in public messaging and interventions around meat consumption. They also called for more research on how to make minimally-processed plant-based alternatives more appealing to meat eaters.

 

“Small shifts in diet across a population can add up to significant environmental benefits,” Downs said. “Finding ways to make those shifts that resonate with consumers’ existing priorities around food choice will be key. This needs to happen alongside policies aimed at making changes to the environments in which we make those food choices. For example, including sustainability considerations in public procurement policies or making tasty plant-based meals more available and affordable.”

 

The study, conducted in collaboration with researchers from Columbia University’s Climate School, Cornell University, and the International Food Policy Research Institute, was funded by the Stavros Niarchos Foundation.

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Journal

Appetite

DOI

10.1016/j.appet.2024.107667 

Method of Research

Survey

Subject of Research

People

Article Title

Sustainability considerations are not influencing meat consumption in the US

Article Publication Date

6-Sep-2024

 

Someone flirts with your spouse. Does that make your partner appear more attractive?

The simplified formula of “more attention equals more desire” doesn’t seem to apply to established relationships

University of Rochester

Picture this: You’re at a bar when someone starts hitting shamelessly on your spouse or significant other, who doesn’t flirt back. As the scene unfolds, your base instincts kick in—annoyance, anger, jealousy—followed by a heightened sexual desire for your partner. You’re ready to reclaim the attention that should be rightfully yours, correct?

Not necessarily, according to a new study in the Journal of Sex Research by researchers at Reichman University in Herzliya, Israel, and the US-based University of Rochester. Instead, the researchers discovered a surprising twist: despite the fact that your significant other did not reciprocate the advances, your own attraction to your partner begins to wane, and your desire to continue investing in that relationship diminishes.

At first glance, the reaction seems paradoxical, notes the study’s lead author Gurit Birnbaum, a professor of psychology at Reichman University. A substantial body of prior research has shown that when searching for a partner, we frequently rely on social cues. One such cue, known as mate choice copying, occurs in both humans and animals. Think of it as a shortcut to identifying desirable partners: seeing others interested in a potential mate often makes that person appear more attractive and desirable.

But the simplified formula of “more attention equals more desire” doesn’t seem to apply to established relationships.

”The problem is, once we have established a relationship, we become concerned about something called mate poaching—the idea that a competitor might lure our partner away,” explains coauthor Harry Reis, a professor in Rochester’s Department of Psychology and the University’s Dean’s Professor.

While the bulk of earlier research has largely focused on the initial stage of mate selection and the start of new partnerships, this latest study looks at the effects of unsolicited flirting on an established relationship.

Research has shown that people tend to use a mix of positive and negative approaches to keep their partners close. Giving gifts and spending quality time together are examples of positive tactics, says Birnbaum, while controlling a partner’s time is a negative approach.

“While some might try to make their partner jealous by seeking attention from others, possibly to feel more desired or secure, our research shows this tactic often backfires.”

What happens next is important.

“When a partner’s likelihood of being attracted to someone else is perceived as high, such as when they receive attention from others, people tend to abandon the positive tactics,” says Birnbaum.

Indeed, the fear of losing a partner may trigger a cascade of defensive reactions designed to protect us from hurt, including emotional distancing and withdrawing investment in the relationship, hoping to soften the blow if our fears materialize.

These defensive distancing responses, says Birnbaum, are designed to avoid a “potential blow to one’s self-esteem from rejection rather than risk further attachment to a partner whose commitment could be compromised by rival suitors.”

Three experiments put unsolicited flirting to the test

The team tested Israeli participants’ reactions across three separate experiments, using visualization, virtual reality, and recall techniques.

Participants in all three studies were in monogamous, mixed-sex relationships of at least four months. They were exposed to situations in which their real-life partners received unsolicited flirtatious advances. (All three experiments used control groups in which the participants’ partners encountered a neutral interaction with another person). Then, participants rated their sexual desire for their partner, their interest in deterring potential rivals, and their own relationship-maintaining efforts as expressed, for example, in the kind act of taking over a chore for their partner.

For the first experiment, 244 participants (126 women, 118 men) were asked to imagine a scenario where someone else showed interest in their partner (without the partner’s reciprocation), or interacted neutrally (for the control group). Next, participants were instructed to describe a sexual fantasy about their partner in a narrative format. Independent raters coded these fantasies for expressions of desire for the partner and the degree to which participants prioritized their partner’s pleasure over their own sexual desires. The team considered lower values as signs of defensive distancing and sexual disengagement.

In the second experiment, the researchers used virtual reality to create a realistic, yet controlled environment to study participants’ reactions to unwanted attention towards their romantic partners. To that end, 132 undergraduate students (66 women, 66 men) put on VR headsets and were transported to a bustling bar where they watched their real-life partners interact with a virtual stranger, who either flirted with their partner or remained neutral. Using VR, the team was able to create a safe environment to study the very real emotions of jealousy and possessiveness—without the risk of study participants’ coming to blows or causing a bar brawl.

In the third experiment, 190 participants (101 women and 89 men) were asked to recall and describe a past episode in their relationship where someone had either expressed unreciprocated interest in their partner or had interacted with their partner in a neutral manner.

The team found that study participants reacted to a stranger’s showing interest for their partner by feeling less desire for their partner, a reduced interest in investing in the relationship, and an increased interest in thwarting potential rivals.

Flirt at your own risk

The study’s biggest takeaway for your everyday romantic life? “Don’t flirt with others if you want your partner to be happy with you,” says Reis.

“While some might try to make their partner jealous by seeking attention from others, possibly to feel more desired or secure, our research shows this tactic often backfires,” echoes Birnbaum. “Instead of strengthening the relationship, it can damage the very connection it aims to enhance.”

The study is supported by the Israel Science Foundation, the Binational Science Foundation, and the European Union’s Horizon 2020 research and innovation program.

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Journal

The Journal of Sex Research

DOI

10.1080/00224499.2024.2391105 

Method of Research

Experimental study

Subject of Research

People

Article Title

When Your Partner is Being Flirted With: The Impact of Unsolicited Attention on Perceived Partner Desirability and Mate Retention Efforts

 

Do no harm: Researchers help doctors identify words they should never say to patients

These “never words” can cause harm if said by clinicians to patients and families dealing with serious illness

Texas A&M University

 

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Texas A&M University Distinguished Professor of Marketing Dr. Leonard Berry

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Credit: Texas A&M University Mays Business School

Seriously ill patients and family members face intense emotional suffering, and researchers, including a Texas A&M University professor, say clinicians must engage in “compassionate communication” as part of the treatment process. They have identified so-called “never words” that should not be said under any circumstances; offer methods for clinicians to identify their own never words; and provide more helpful language to use instead.

In a recent paper published in Mayo Clinic Proceedings, Texas A&M University Distinguished Professor of Marketing at Mays Business School Dr. Leonard Berry and co-authors from Henry Ford Health in Detroit assert that in spite of rapid progress in the treatment of serious illnesses such as cancer, advanced heart failure and end-stage pulmonary disease, certain “timeless” aspects of the patient experience remain, like fear.

“Communicating the nature, purpose and intended duration of often complex treatments, and setting realistic expectations about what they offer still comes up against timeless patient experiences: fear, intense emotions, lack of medical expertise, and the sometimes unrealistic hope for cure,” they write. The “intense, daunting nature of these conversations” may cause clinicians to resort to learned communication habits or declarative statements.

Even a single word may scare patients and families, make them feel disempowered, and possibly negate the effectiveness of shared decision making.

“Because seriously ill patients and their families are understandably frightened, they ‘hang’ on every word their doctor will say,” notes Berry, a senior fellow at the Institute for Healthcare Improvement. “Serious illness is not only a matter of physical suffering, but also emotional suffering. The doctor’s behavior, including their verbal and nonverbal communication, can exacerbate or reduce emotional suffering.”

Berry said all too often, doctors use insensitive language in communicating critical information, and commonly do so without realizing the needless alarm or offense they have inflicted.

Never Words

Patients and families need to feel “psychologically safe” in communicating with health care professionals, Berry said, including in expressing concern about the proposed treatment plan or in conveying their fears. The researchers say if doctors respond using “never words,” they may undermine patients’ and families’ confidence to speak freely.

“Never-words are conversation stoppers,” the researchers write. “They seize power from the very patients whose own voices are essential to making optimal decisions about their medical care.”

Utilizing clinician surveys, the researchers identified never words, including:

• “There is nothing else we can do.”
• “She will not get better.”
• “Withdrawing care.”
• “Circling the drain.”
• “Do you want us to do everything?”
• “Fight” or “battle.”
• “I don’t know why you waited so long to come in.”
• “What were your other doctors doing/thinking?”

In another study specific to cancer care, clinicians were asked for words or phrases they would never use with a patient, with the top results including:

• “Let’s not worry about that now.”
• “You are lucky it’s only stage 2.”
• “You failed chemo.”

‘“Let’s not worry about that now’ is not only a non-answer to a patient’s legitimate concern, it’s dismissive,” the researchers said. Pointing out that cancer is in an early stage is “presumptive, assuming the patient should feel gratitude, without allowing room for the patient’s anxiety and fear in having cancer.” And, Berry said, patients do not fail chemo; chemo fails patients.

What Doctors Should Say Instead

Health care professionals can start a dialogue by inviting honest, thoughtful inquiries and responses from patients and families. “They should learn to recognize words and phrases that unintentionally frighten, offend, or diminish agency and work to reimagine their own communication,” the researchers stated.

Berry says such an opportunity can arise when doctors encourage patients to speak up. “Something as simple as, ‘What questions do you have for me?’ rather than, ‘Do you have any questions?’ invites candid conversation,” he said.

As for the never words, the researchers recommend alternative language, as well as the rationale, for each. For example, instead of, “She will not get better,” the doctor could say, “I’m worried she won’t get better.” The rationale being the provider will replace a firm negative prediction with an expression of concern.

Using words like “fight” and “battle” may imply that sheer will can overcome illness and patients may feel as if they’re letting loved ones down by not fighting hard enough. Instead, doctors could say, “We will face this difficult disease together” to make it clear patients have a team behind them.

Spreading Awareness

Medical groups and educators can bring attention to never words in multiple ways, the researchers said, including by integrating the discussion into courses and professional development.

“The emphasis in medical school is understandably on the science of medicine, but it is so important to incorporate communications training into the curriculum,” Berry said. “A key opportunity is medical school students and graduates having superb patient-centered, skilled communicators as role models in their clinical training during medical school and residency.”

Mentorships are also invaluable as more experienced doctors can share communication techniques that they’ve found to be successful and which to avoid. The study notes, “Mentors can not only disclose harmful phrases that they personally have abandoned and replaced by more generative phrases but may also model walking back language that lands poorly…Such mentorship facilitates progress in how future generations of clinicians interact with patients and stimulates open dialogue about the added suffering and disempowerment that poor, unmindful communication can cause.”

Collaborators on the study are Dr. Rana Lee Adawi Awdish, critical care physician and medical director of care experience, Henry Ford Health; and Dr. Gillian Grafton, advanced heart failure and transplant cardiologist, Cardiac Intensive Care Unit, Henry Ford Health.

By Lesley Henton, Texas A&M University Division of Marketing and Communications

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Journal

Mayo Clinic Proceedings

DOI

10.1016/j.mayocp.2024.05.011 

Article Title

Never-Words: What Not to Say to Patients With Serious Illness

 

Does more virtual care mean more low-value care? Study suggests no

Analysis of 2022 data from Michigan Medicare participants shows that despite worries, use of unneeded scans & tests didn’t rise at primary care practices that embraced virtual care the most

Michigan Medicine - University of Michigan

 

video: 

Dr. Terrence Liu of the University of Michigan discusses a study looking at telehealth use by primary care practices, and associated use of eight types of low-value care.

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Credit: University of Michigan

Before 2024 ends, Congress will decide whether to keep or change rules about telehealth, or let them expire. And even though the decision will focus on Medicare’s payment for virtual patient care, it will likely impact telehealth access for people with other kinds of health insurance too.

Now, a new University of Michigan study suggests that policymakers can rest easier about one of the top worries about telehealth: that virtual care will drive up the use of tests and scans that patients don’t need, wasting money and resources.

In fact, the study shows that low-value care didn’t rise faster at primary care practices that used telehealth the most, compared with those that used it the least.

And in some cases, the high-telehealth-use practices saw a faster drop in low-value care.

The study, published in JAMA Network Open, focuses on eight low-value tests, scans and procedures that experts agree aren’t needed in certain groups of patients. This included blood tests to screen for prostate cancer risk in men over age 75, CT scans for people with uncomplicated sinus infections or back pain, Pap smears to look for early signs of cervical cancer in women over age 65, and colon cancer screening in people over age 85.

While some have worried that such low-value care might rise when physicians and other providers see more patients virtually and can’t conduct physical exams, the study showed this did not happen.

“Our findings are reassuring in the context of current telehealth policy decisions, because there has been concern that telehealth might be increasing access to care to a degree that leads to unnecessary visits and wasteful screening or diagnostic testing ,’ said lead author Terrence Liu, M.D., M.S., a primary care physician in the Division of General Medicine at U-M Health and National Clinician Scholar at the U-M Institute for Healthcare Policy and Innovation.

He and his colleagues used data from nearly 578,000 Michiganders covered by traditional Medicare, who saw providers in more than 2,550 primary care clinics between 2019 and 2022. The researchers divided those clinics into three groups of high, medium and low telehealth use based on how frequently they billed Medicare for virtual care visits by video, phone and other virtual care services in 2022. They also accounted for differences in the number of patients each clinic saw.

In addition to failing to show a rise in low-value care at high-telehealth practices, the study also confirms an earlier U-M finding using data from 2021. That study addressed another fear about virtual care: that the rate of in-person visits would increase because of a need for follow-up appointments to address something identified in virtual visits. In both that study and the new one using data from 2022, the rate of in-person visits decreased in the telehealth era.

Liu and colleagues zeroed in on the eight low-value care types because they’ve been studied by others and have been targeted for reduction by major medical professional societies.

In six of the eight types of care, the rate of patients receiving them dropped or stayed about the same between 2019 and 2022, no matter how much telehealth a clinic provided.

But in two cases – cervical cancer screening for women over 65, and ongoing blood monitoring for a thyroid hormone in people with hypothyroidism – the medium- and high-telehealth clinics showed an even faster drop than the low telehealth clinics.

The new study focuses on types of low-value care that occurs most commonly in the primary care setting, using well-established methods for identifying low-value care in Medicare records. It took into account the trend in recent years for an increasing percentage of older adults to choose  Medicare Advantage rather than traditional Medicare.

While the new study focuses on data from Michigan that the team obtained from the Michigan Value Collaborative, Liu and colleagues now plan to repeat the analysis using a sample of national Medicare data.

Liu worked on the study with senior author Chad Ellimoottil, M.D., M.S., who directs virtual care for the U-M Medical School’s faculty group practice, called the Michigan Medical Group. A. Mark Fendrick, M.D., the director of the U-M Center for Value Based Insurance Design, is a co-author.

“I view telehealth as a way to supplement providers’ usual ways of delivering care, and wouldn’t expect it to necessarily improve health care quality or decrease cost by reducing low-value care on its own,” said Liu. “We need to find ways to best integrate telehealth into our current healthcare delivery system and think of how to reduce low-value care in both the in-person and virtual setting.”

“These important findings suggest that regardless of whether initial care recommendations are made in person or virtually, factors such as access to care, out of pocket costs and the time and effort required by patients to complete both high and low-value medical services play an important role in their use,” said Fendrick.

Liu, Ellimoottil, Fendrick and co-authors Michael Thompson, Ph.D., Chiang-Hua Chang, Ph.D., and Jeffrey McCullough, Ph.D. are all members of the U-M Institute for Healthcare Policy and Innovation.

Citation: Primary care practice telehealth use and low-value care services, JAMA Network Open, DOI:10.1001/jamanetworkopen.2024.45436

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Journal

JAMA Network Open

DOI

10.1001/jamanetworkopen.2024.45436 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

Primary care practice telehealth use and low-value care services

Article Publication Date

7-Nov-2024