AN INVESTIGATION OF THE ACCEPTABILITY OF VIDEOCONFERENCING WITHIN A SCHOOL-BASED BEHAVIORAL CONSULTATION FRAMEWORK

George SM, Agosto Y, Rothenberg WA, Howe E, Velasquez C, Mansoor E, Garcia EG, Bulotsky-Shearer RJ, Natale R. Virtual robotic telepresence early childhood mental health consultation to childcare centers in the aftermath of COVID-19: training approaches and perceived acceptability and usefulness

Introduction

Childcare center closures during COVID-19 impacted education for approximately 40 million children nationwide. Unfortunately, COVID-19 restrictions significantly limited the extent that outside personnel could provide in-person support to educators, resulting in the need for innovative approaches to meet childcare centers' needs. A virtual robotic telepresence approach was applied to early childhood consultation models to promote child resilience while mitigating COVID-19 risks. The goal of this study was to examine how training influenced consultants' and childcare staff uptake of the virtual robotic telepresence consultation approach and their acceptance of this technology.

Methods

Ten early childhood consultants received multimedia/simulation training and weekly communities of practice related to virtual telepresence robotic consultation. Telepresence robotic consultation equipment was deployed to 16 childcare centers in a diverse multilingual metropolitan area as a part of a larger randomized controlled trial. Consultants trained childcare staff (14 center directors and 58 teachers) on how to receive virtual telepresence robotic consultation. Demographic information and measures of technology acceptability and uptake were collected from childcare staff and consultants. A mixed methods approach was used including multilevel modeling and focus groups to examine consultation uptake, acceptability, barriers, and facilitators of virtual telepresence robotic consultation implementation.

Results

Consultants and childcare staff generally perceived the virtual telepresence consultation approach to be useful and easy to use. Consultant perceptions of the acceptability of technology did not change over time. Childcare staff, center, and consultant factors impacted the uptake of the virtual robotic telepresence consultation approach and childcare staff acceptance of the technology. Focus groups revealed that consultants believed that additional hands-on training with childcare staff would have benefited implementation and expressed a desire for a hybrid approach for consultation.

Discussion

Perceptions of telepresence robotic consultation acceptability are discussed, including future recommendations for training.

A Survey of Staff Training and Performance Management Practices: An Update

The field of behavior analysis has experienced marked growth in the number of credentialed professionals over the last decade. This growth may have implications for the quality of staff training, performance management, and supervision practices provided in human service settings. The purpose of this survey was to extend DiGennaro Reed and Henley (2015) by surveying credentialed and aspiring behavior analytic professionals on the staff training, performance management, and supervision practices available at their current place of employment. Three main differences were observed in relation to the findings of DiGennaro Reed and Henley. The current findings indicate notable changes in the demographic characteristics of survey respondents. In addition, we observed modest increases in the use of best practices for initial and ongoing training and performance management. Results also indicate several areas of concern regarding the provision of supervisory skills training. • Results revealed improvements in the percentage of respondents who received initial or preservice training compared to DiGennaro Reed and Henley (2015). However, employers primarily rely on instructions and modeling to train their employees. • Findings revealed greater reliance on asynchronous and synchronous online training modalities compared to DiGennaro Reed and Henley (2015). • Results revealed a slight shift in the percentage of respondents who reported receiving ongoing training compared to DiGennaro Reed and Henley (2015). In the present study, BCaBAs and RBTs generally received ongoing training; however, fewer BCBAs reported receiving ongoing training. • The reported use of performance management practices improved compared to DiGennaro Reed and Henley (2015). That is, a higher percentage of respondents reported being observed at work while carrying out their job responsibilities. • Of the respondents who supervise staff, less than half of them reported receiving supervisory skills training. And only half of those respondents reported that their training prepared them to supervise others.

Development of an Online Training Platform and Implementation Strategy for School-Based Mental Health Professionals in Rural Elementary Schools: A Mixed-Methods Study

Children in rural settings are less likely to receive mental health services than their urban and suburban counterparts and even less likely to receive evidence-based care. Rural schools could address the need for mental health interventions by using evidence-based practices within a tiered system of supports such as positive behavioral interventions and supports. However, very few school professionals, with or without mental health training, have received training on evidence-based practices. Rural schools need implementation strategies focused on training to prepare school personnel for the implementation of interventions with fidelity. Little is known about training strategies that are feasible and appropriate for the rural school context. User-centered design is an appropriate framework for the development of training strategies for professionals in rural schools because of its participatory approach and the development of products that fit the context where they are going to be used. The purpose of the study was to develop and assess components of an online training platform and implementation strategy based on the user-centered design. Quantitative and qualitative data from 25 participants from an equal number of schools in rural areas of Pennsylvania were used in the study. A mixed-methods design utilizing complementary descriptive statistics and theme analyses indicated that the training platform and implementation strategy were perceived as highly acceptable, appropriate, feasible and usable by school professionals. The resulting training platform and implementation strategy will fill a void in the training literature in rural schools.

Feasibility of Virtual Simulation-Based Diabetes Foot Care Education in Patients with Diabetes in Ethiopia: Protocol for a Randomized Controlled Trial

INTRODUCTION

Diabetes mellitus is a rapidly growing global public health problem; the number of adults with diabetes is expected to increase from 424.9 million in 2017 to 628.6 million in 2045. Approximately 80% of diabetic patients live in low- and middle-income countries where access to care may be limited. For example, in Ethiopia, diabetes care is often rudimentary, and formal, structured diabetes education is almost non-existent. One potential solution to the lack of diabetes management education for patients could be virtual simulation-based diabetes education incorporating the contextual realities of patients in Ethiopia. Despite its great potential to improve glycemic control, delay diabetes-related complications and reduce mortality associated with diabetes, the feasibility of virtual simulation-based diabetes self-management education has not been studied in low- and middle-income settings.

OBJECTIVE

The purpose of the current study is to evaluate the feasibility of a virtual simulation-based Diabetes Foot Care Education (DFCE) program among adult patients with diabetes in Ethiopia.

METHODS

A randomized controlled feasibility study including participants from University of Gondar Referral Hospital (UoGRH) will be conducted. A sample of 40 participants will be recruited, of which 20 participants will receive the virtual simulation-based education program, and the other 20 participants will continue with their usual diabetes care. After the education program, a questionnaire and structured interview will be used to explore the feasibility (acceptability, practicality) and the potential impact of virtual simulation-based DFCE intervention in patients with diabetes. Data will be analyzed using SPSS version 25 using descriptive statistics, independent t-tests, paired sample t-test, and factorial ANOVA at significance levels of less than 0.05.

DISCUSSION

Our study seeks to understand the perceived usefullness and usability of virtual simulation-based diabetes foot care education on behavioural (diabetes foot-care knowledge, foot self-care practices, and foot self-care efficacy). Furthermore, the study will provide insight to assist in the development of technologically assisted and contextually designed DFCE programs.

TRIAL REGISTRATION NUMBER

NCT04841291 (ClinicalTrials.gov Identifier).

Ethics and acceptance of smart homes for older adults

Societal challenges associated with caring for the physical and mental health of older adults worldwide have grown at an unprecedented pace, increasing demand for health-care services and technologies Despite the development of several assistive systems tailored to older adults, the rate of adoption of health technologies is low. This review discusses the ethical and acceptability challenges resulting in low adoption of health technologies specifically focused on smart homes for older adults. The findings have been structured in two categories: Ethical Considerations (Privacy, Social Support, and Autonomy) and Technology Aspects (User Context, Usability, and Training). The findings conclude that older adults community is more likely to adopt assistive systems when four key criteria are met. The technology should: be personalized toward their needs, protect their dignity and independence, provide user control, and not be isolating. Finally, we recommend researchers and developers working on assistive systems to: (1) provide interfaces via smart devices to control and configure the monitoring system with feedback for the user, (2) include various sensors/devices to architect a smart home solution in a way that is easy to integrate in daily life, and (3) define policies about data ownership.

Developing and Enhancing Adherence to a Telehealth ABA Parent Training Curriculum for Caregivers of Children with Autism

The current COVID-19 pandemic poses unique challenges to the delivery of applied behavior analysis (ABA) services, and there has been a growing demand for evidence-based practices on how to develop a telehealth ABA service model. The current article provides a detailed technological guide on how to develop a telehealth ABA parent training curriculum. Our model also includes a series of brief acceptance and commitment training (ACT) protocols to enhance parental adherence. We provide the details for replicating our telehealth model and also demonstrate its effectiveness. To begin, a step-by-step guide on how to develop this curriculum is presented, as well as protocols used in a 60-day telehealth ABA parent training program. Afterward, we describe a randomized controlled trial design to examine the effectiveness of this protocol. Thirteen families from the southern Illinois region participated in the curriculum before the COVID-19 outbreak. Obtained data indicated training was effective to teach skills, and parents with supplemental ACT material made significantly more progress than those in the control group, t(11) = 2.36, p = .038. Halfway through the training, the outbreak of COVID-19 occurred, and parents in the ACT group were more likely to continue the program, whereas parents in the control group were significantly more likely to postpone their participation, χ2 = 6.96, p = .008. Social validity measures indicated that parents rated the curriculum favorably. Limitations and suggestions for practitioners are discussed.

Technology Acceptance in Mobile Health: Scoping Review of Definitions, Models, and Measurement

BACKGROUND

Designing technologies that users will be interested in, start using, and keep using has long been a challenge. In the health domain, the question of technology acceptance is even more important, as the possible intrusiveness of technologies could lead to patients refusing to even try them. Developers and researchers must address this question not only in the design and evaluation of new health care technologies but also across the different stages of the user's journey. Although a range of definitions for these stages exists, many researchers conflate related terms, and the field would benefit from a coherent set of definitions and associated measurement approaches.

OBJECTIVE

This review aims to explore how technology acceptance is interpreted and measured in mobile health (mHealth) literature. We seek to compare the treatment of acceptance in mHealth research with existing definitions and models, identify potential gaps, and contribute to the clarification of the process of technology acceptance.

METHODS

We searched the PubMed database for publications indexed under the Medical Subject Headings terms "Patient Acceptance of Health Care" and "Mobile Applications." We included publications that (1) contained at least one of the terms "acceptability," "acceptance," "adoption," "accept," or "adopt"; and (2) defined the term. The final corpus included 68 relevant studies.

RESULTS

Several interpretations are associated with technology acceptance, few consistent with existing definitions. Although the literature has influenced the interpretation of the concept, usage is not homogeneous, and models are not adapted to populations with particular needs. The prevalence of measurement by custom surveys suggests a lack of standardized measurement tools.

CONCLUSIONS

Definitions from the literature were published separately, which may contribute to inconsistent usage. A definition framework would bring coherence to the reporting of results, facilitating the replication and comparison of studies. We propose the Technology Acceptance Lifecycle, consolidating existing definitions, articulating the different stages of technology acceptance, and providing an explicit terminology. Our findings illustrate the need for a common definition and measurement framework and the importance of viewing technology acceptance as a staged process, with adapted measurement methods for each stage.

Using telehealth to teach valued skills to adults with intellectual and developmental disabilities

Telehealth uses electronic information and telecommunication technologies to deliver long-distance clinical services. It has successfully been used by clinical professionals to teach family and staff members to provide evidence-based assessment and treatment procedures. There is no research to date, however, evaluating the use of telehealth to directly teach individuals with intellectual and developmental disabilities (IDD). Thus, we evaluated the efficacy of a telehealth intervention using total task chaining with least-to-most prompting delivered via videoconference to 2 adults with IDD. Both participants demonstrated low independent responding during baseline with enhanced written instructions present. During intervention, which included vocal and model prompting, both participants met the mastery criterion for each skill in fewer than 15 sessions, which maintained after 2 weeks. Finally, both participants expressed satisfaction with the goals, procedures, and effects of the intervention. We discuss the broader scope of the intervention for individuals with disabilities when face-to-face services may not be feasible.

A comparison of problem identification interviews conducted face-to-face and via videoconferencing using the consultation analysis record

School psychologists who experience challenges delivering face-to-face consultation may utilize videoconferencing to facilitate their consultation activities. Videoconferencing has been found to be an effective method of service delivery in related fields and emerging research suggests that it may be effective for providing teacher training and support in school settings. In this exploratory investigation, we used the Consultation Analysis Record (Bergan & Tombari, 1975) and its four indices to assess the effectiveness of conducting problem identification interviews via videoconferencing versus face-to-face. Overall, findings indicated significant differences across these two conditions, with videoconference interviews coded as having higher indices of content relevance, process effectiveness, and message control, but lower content focus, compared to face-to-face interviews. As these indices have been positively associated with favorable consultation outcomes, the results provide initial support for the effectiveness of consultation delivered via videoconferencing.