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Green G, Barragan NC, Abraham J, Chen S, Kuo T. Delivery of Comprehensive Medication Management and Other Clinical Services via Telehealth by Pharmacy Type. J Pharm Pract 2024; 37:625-631. [PMID: 36803060 DOI: 10.1177/08971900231158934] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Background: The recent coronavirus pandemic accelerated the need to deliver pharmacy-related services remotely. Objective: To describe experiences with providing comprehensive medication management (CMM) and other clinical services via telehealth by pharmacy type, before and during the COVID-19 pandemic. Methods: An online survey of pharmacists, representing 27 pharmacies, was conducted to capture telehealth usage in three pharmacy types: independently owned, integrated into a clinical setting, and retail chain. A sub-analysis was performed to assess if providing CMM services via telehealth helped, resulted in no change, or worsened the care of different patient groups (e.g., those with diabetes, were low-income, aged 65+ years). Results: During the pandemic, telehealth usage among independently owned pharmacies and those integrated into a clinical setting increased, but no change occurred among retail chain pharmacies. This usage increase in the first two pharmacy types occurred despite limited investments in connectivity-related resources to support telehealth services. Pharmacists from both independently owned pharmacies (63%) and those integrated into a clinical setting (89%) reported CMM via telehealth reached patients they would not otherwise have been able to reach during the pandemic. Most pharmacists/pharmacies found telehealth to be a feasible and acceptable method of delivering CMM. Conclusion: Pharmacists and pharmacies are now experienced with and have interest in continuing CMM via telehealth, even as the pandemic recedes. However, investments in telecommunications resources, training support, technical assistance, and continued telehealth reimbursement from health plans are needed to sustain this service delivery model.
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Affiliation(s)
- Gabrielle Green
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Noel C Barragan
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, USA
| | - Jessica Abraham
- University of Southern California Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, Los Angeles, CA, USA
| | - Steven Chen
- University of Southern California Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, Los Angeles, CA, USA
| | - Tony Kuo
- Department of Family Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, CA, USA
- Population Health Program, University of California, Los Angeles Clinical and Translational Science Institute, Los Angeles, CA, USA
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2
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Zettergren L, Larsson EC, Hellsten L, Kosidou K, Nielsen AM. Implementing digital sexual and reproductive health care services in youth clinics: a qualitative study on perceived barriers and facilitators among midwives in Stockholm, Sweden. BMC Health Serv Res 2024; 24:411. [PMID: 38566080 PMCID: PMC10988956 DOI: 10.1186/s12913-024-10932-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/29/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Digital health care services have the potential to improve access to sexual and reproductive health care for youth but require substantial implementation efforts to translate into individual and public health gains. Health care providers are influential both regarding implementation and utilization of the services, and hence, their perceptions of digital health care services and the implementation process are essential to identify and address. The aim of this study was to explore midwives' perception of digital sexual and reproductive health care services for youth, and to identify perceived barriers and facilitators of the implementation of digital health care provision in youth clinics. METHODS We performed semi-structured interviews with midwives (n = 16) working at youth clinics providing both on-site and digital sexual and reproductive health care services to youth in Stockholm, Sweden. Interview data were analyzed using a content analysis approach guided by the Consolidated Framework for Implementation Research (CFIR). RESULTS Midwives acknowledged that the implementation of digital health care improved the overall access and timeliness of the services at youth clinics. The ability to accommodate the needs of youth regarding their preferred meeting environment (digital or on-site) and easy access to follow-up consultations were identified as benefits of digital health care. Challenges to provide digital health care included communication barriers, privacy and confidentiality concerns, time constraints, inability to offer digital appointments for social counselling, and midwives' preference for in person consultations. Experiencing organizational support during the implementation was appreciated but varied between the respondents. CONCLUSION Digital sexual and reproductive health care services could increase access and are valuable complements to on-site services in youth clinics. Sufficient training for midwives and organizational support are crucial to ensure high quality health care. Privacy and safety concerns for the youth might aggravate implementation of digital health care. Future research could focus on equitable access and youth' perceptions of digital health care services for sexual and reproductive health.
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Affiliation(s)
- Linn Zettergren
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset 171 77, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Region Stockholm, SE-104 31, Stockholm, Box 45436, Sweden
| | - Elin C Larsson
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset 171 77, Stockholm, Sweden
- Department of Womens and Childrens Health, Tomtebodavägen 18a, Widerströmska Huset, 171 77, Stockholm, Sweden
| | - Lovisa Hellsten
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset 171 77, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Region Stockholm, SE-104 31, Stockholm, Box 45436, Sweden
| | - Kyriaki Kosidou
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset 171 77, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Region Stockholm, SE-104 31, Stockholm, Box 45436, Sweden
| | - Anna Maria Nielsen
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset 171 77, Stockholm, Sweden.
- Center for Epidemiology and Community Medicine, Region Stockholm, SE-104 31, Stockholm, Box 45436, Sweden.
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3
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Berardi C, Antonini M, Jordan Z, Wechtler H, Paolucci F, Hinwood M. Barriers and facilitators to the implementation of digital technologies in mental health systems: a qualitative systematic review to inform a policy framework. BMC Health Serv Res 2024; 24:243. [PMID: 38408938 PMCID: PMC10898174 DOI: 10.1186/s12913-023-10536-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 12/28/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Despite the potential for improved population mental health and wellbeing, the integration of mental health digital interventions has been difficult to achieve. In this qualitative systematic review, we aimed to identify barriers and facilitators to the implementation of digital technologies in mental healthcare systems, and map these to an implementation framework to inform policy development. METHODS We searched Medline, Embase, Scopus, PsycInfo, Web of Science, and Google Scholar for primary research articles published between January 2010 and 2022. Studies were considered eligible if they reported barriers and/or facilitators to the integration of any digital mental healthcare technologies. Data were extracted using EPPI-Reviewer Web and analysed thematically via inductive and deductive cycles. RESULTS Of 12,525 references identified initially, 81 studies were included in the final analysis. Barriers and facilitators were grouped within an implementation (evidence-practice gap) framework across six domains, organised by four levels of mental healthcare systems. Broadly, implementation was hindered by the perception of digital technologies as impersonal tools that add additional burden of care onto both providers and patients, and change relational power asymmetries; an absence of resources; and regulatory complexities that impede access to universal coverage. Facilitators included person-cantered approaches that consider patients' intersectional features e.g., gender, class, disability, illness severity; evidence-based training for providers; collaboration among colleagues; appropriate investment in human and financial resources; and policy reforms that tackle universal access to digital health. CONCLUSION It is important to consider the complex and interrelated nature of barriers across different domains and levels of the mental health system. To facilitate the equitable, sustainable, and long-term digital transition of mental health systems, policymakers should consider a systemic approach to collaboration between public and private sectors to inform evidence-based planning and strengthen mental health systems. PROTOCOL REGISTRATION The protocol is registered on PROSPERO, CRD42021276838.
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Affiliation(s)
- Chiara Berardi
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia.
| | - Marcello Antonini
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Department of Health Policy, London School of Economics and Political Science, London, WC2A 2AE, UK
| | - Zephanie Jordan
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Heidi Wechtler
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Francesco Paolucci
- Newcastle Business School, The University of Newcastle, Hunter St & Auckland St, 2300, Newcastle, NSW, Australia
| | - Madeleine Hinwood
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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Bdair IA. Perceptions of pre-licensure nursing students toward telecare and telenursing. Inform Health Soc Care 2024; 49:42-55. [PMID: 38205799 DOI: 10.1080/17538157.2024.2303642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Telehealth transforms the healthcare system and provides the population with equal access to healthcare services at distance. This study aimed to investigate nursing students' perceptions toward telenursing. Students' knowledge, attitudes, advantages, disadvantages, barriers, and factors that affect the intention toward telenursing implementation were addressed. This study was conducted using a descriptive design. The study participants were 313 undergraduate nursing students. Data were gathered through a web-based survey from June to August 2022 and analyzed using SPSS version 22. Fifty-four-point-six percent (54.6%) of the students were male and 45.4% were female. Around one-fourth were internship students. Most students had access to the internet 97.4%. The results revealed that nursing students have positive perceptions toward telenursing. Their overall competencies in terms of knowledge, proficiency, awareness, and familiarity were moderate. Students raised some disadvantages and difficulties regarding telenursing; meanwhile, more advantages and suggestions to overcome the disadvantages were reported. It is of utmost importance that nursing education integrates telenursing content and practice to prepare future nurses for the successful implementation of telenursing. More research is still needed to examine the impact of telenursing on nursing practice. Nursing administrators must develop appropriate and prompt interventions to respond to the dramatically changing healthcare environment.
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Affiliation(s)
- Izzeddin A Bdair
- Nursing Department, Al-Ghad College for Applied Medical Sciences, Riyadh, Saudi Arabia
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5
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Zemlak JL, Wilson P, VanGraafeiland B, Rodney T. Telehealth and the Psychiatric Mental Health Nurse Practitioner: Beyond the COVID-19 Pandemic. J Am Psychiatr Nurses Assoc 2024; 30:174-179. [PMID: 34486424 DOI: 10.1177/10783903211045119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Examine the advantages, disadvantages, and challenges of telehealth for the psychiatric mental health nurse practitioner (PMHNP) in practice and student education. Describe areas for future research and policy development regarding telehealth in PMHNP practice and training during and beyond the COVID-19 pandemic. METHODS Review current evidence, standards of practice, and education for the PMHNP. RESULTS Recent rapid pandemic-related shifts in utilization of telehealth for clinical practice and student education have highlighted the advantages, disadvantages, and areas in need of additional study. CONCLUSIONS Postpandemic telehealth care delivery will likely persist or expand. PMHNPs must advocate for high practice and education standards.
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Affiliation(s)
- Jessica L Zemlak
- Jessica L. Zemlak, PhD, MSN, FNP-BC, PMHNP-BC, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Patty Wilson
- Patty Wilson, PhD, MSN, PMHNP-BC, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Brigit VanGraafeiland
- Brigit VanGraafeiland, DNP, CRNP, CNE, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Tamar Rodney
- Tamar Rodney, PhD, MSN, PMHNP-BC, Johns Hopkins School of Nursing, Baltimore, MD, USA
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6
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Wu DC, Zhao X, Wu J. Online Physician-Patient Interaction and Patient Satisfaction: Empirical Study of the Internet Hospital Service. J Med Internet Res 2023; 25:e39089. [PMID: 37616031 PMCID: PMC10485723 DOI: 10.2196/39089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 12/20/2022] [Accepted: 07/12/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND In China, a form of online health service called the internet hospital became a prominent means of patient care when face-to-face visits were not possible during the COVID-19 pandemic to minimize transmission of the SARS-CoV-2 virus. Patients' internet hospital experiences largely depend on online physician-patient interaction. Yet, little is known about how physicians can improve patient satisfaction by using specific communication strategies online. OBJECTIVE This study aimed to identify specific communication strategies to help physicians deliver better quality internet hospital services. We also outline recommendations for hospitals to operate internet hospital platforms more effectively. METHODS A longitudinal data set was collected from an internet hospital platform operated by a top hospital in China. By extracting communication patterns from approximately 20,000 records of online health care services and by controlling the features of service requests, we tested the impacts of response load, more detailed style, and emotional comfort on patient satisfaction. We further explored the effects of these communication patterns in different service contexts. RESULTS Physicians with a low response load, a more detailed style, and expressions of emotional comfort received more positive patient feedback. Response load did not affect patient satisfaction with free online health service, whereas a more detailed style and emotional comfort enhanced satisfaction with free service. Response load significantly reduced patient satisfaction with paid online health service, while a more detailed style had no effect. Compared with free service, emotional comfort more strongly promoted patient satisfaction with paid service. CONCLUSIONS The communication strategies identified can help physicians provide patients with a better internet hospital experience. These strategies require hospitals to schedule each physician's online service period more appropriately. In addition, tailoring the strategies to service situations can facilitate more targeted and effective internet hospital service for patients.
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Affiliation(s)
| | - Xianduo Zhao
- School of Business, Sun Yat-Sen University, Guangzhou, China
| | - Ji Wu
- School of Business, Sun Yat-Sen University, Guangzhou, China
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7
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Watson JD, Pierce BS, Tyler CM, Donovan EK, Merced K, Mallon M, Autler A, Perrin PB. Barriers and Facilitators to Psychologists' Telepsychology Uptake during the Beginning of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085467. [PMID: 37107748 PMCID: PMC10139141 DOI: 10.3390/ijerph20085467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/21/2023] [Accepted: 03/31/2023] [Indexed: 05/11/2023]
Abstract
The COVID-19 pandemic transformed the delivery of psychological services as many psychologists adopted telepsychology for the first time or dramatically increased their use of it. The current study examined qualitative and quantitative data provided by 2619 practicing psychologists to identify variables facilitating and impeding the adoption of telepsychology in the U.S. at the beginning of the COVID-19 pandemic. The top five reported barriers were: inadequate access to technology, diminished therapeutic alliance, technological issues, diminished quality of delivered care or effectiveness, and privacy concerns. The top five reported facilitators were: increased safety, better access to patient care, patient demand, efficient use of time, and adequate technology for telepsychology use. Psychologists' demographic and practice characteristics robustly predicted their endorsement of telepsychology barriers and facilitators. These findings provide important context into the implementation of telepsychology at the beginning of the pandemic and may serve future implementation strategies in clinics and healthcare organizations attempting to increase telepsychology utilization.
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Affiliation(s)
- Jack D. Watson
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Bradford S. Pierce
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Carmen M. Tyler
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Emily K. Donovan
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Kritzia Merced
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
- Central Virginia Veterans Affairs Health Care System, Richmond, VA 23249, USA
| | - Margaret Mallon
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Aaron Autler
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Paul B. Perrin
- Central Virginia Veterans Affairs Health Care System, Richmond, VA 23249, USA
- School of Data Science and Department of Psychology, University of Virginia, Charlottesville, VA 22903, USA
- Correspondence:
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Family Engagement in Services During COVID-19: A Mixed-Methods Study of Caregiver and Staff Perspectives. J Pediatr Health Care 2023; 37:142-152. [PMID: 36372630 PMCID: PMC9554331 DOI: 10.1016/j.pedhc.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/10/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION We examined changes in family engagement before versus during the pandemic in pediatric and family services and perceived facilitators and barriers to family engagement. METHOD We employed a mixed-methods assessment of staff and caregiver perspectives related to pediatric and family medicine clinics and family resource centers in rural northern New England. We used narrative synthesis to analyze qualitative interviews (n = 29) and descriptive statistics for quantitative surveys (n = 108). RESULTS Staff felt they were not doing as well at engaging families during versus prepandemic, identifying numerous facilitators and barriers. We found differences in resources used by families before versus during the pandemic. We identified discordant perspectives between caregivers and staff regarding how well clinics and centers identified and responded to family needs. DISCUSSION Leaders in pediatrics, advanced practice nursing, and related fields can draw on our findings to decide what services and modalities they provide for postpandemic.
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Felker BL, Towle CB, Wick IK, McKee M. Designing and Implementing TeleBehavioral Health Training to Support Rapid and Enduring Transition to Virtual Care in the COVID Era. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 8:1-9. [PMID: 36530382 PMCID: PMC9747532 DOI: 10.1007/s41347-022-00286-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 12/15/2022]
Abstract
As telebehavioral health continues to advance and become part of routine care, there is a need to develop effective training methods. While a consensus on how to best train telebehavioral health has not yet been achieved, this commentary will describe how evidence-based implementation strategies were used to develop a framework to create and implement a telebehavioral health training program that is relevant and enduring for a given audience. Evidence-based implementation strategies included the PARiHS criteria which were used to organize the project. Re-AIM criteria was used to organize chosen outcome measures. Important partnerships were formed to help support infrastructure as well as regional and national reach. A series of Plan-Do-Study-Act loops were used to inform progressive training series. Since April 2020, the Behavioral Health Institute has developed and offered 6 unique telebehavioral health training series, employing both webinar and online formats, and addressing core components as well as more advanced concepts. These series have provided over 19,100 accredited continuing education hours of training through June 2022, to almost 3000 unique learners via webinar and nearly 6800 unique online learners, across 45 states. Evaluations rated these trainings as high quality, relevant, and that material would likely be implemented. Feedback from attendees was considered vital in series planning. This commentary discusses how evidence-based implementation strategies can be used to create a framework upon which to base a training program for health care providers. An example is given on how this framework was used to create successful, relevant, and enduring telebehavioral health training.
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Affiliation(s)
- Bradford L. Felker
- Department of Veterans Affairs, Puget Sound Healthcare System, Seattle, WA USA
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
- Behavioral Health Institute Harborview, University of Washington, Seattle, WA USA
| | - Cara B. Towle
- Workforce and Policy Innovation Center, Behavioral Health Training, University of Washington/UW Medicine, Seattle, WA USA
- Harborview Medical Center, Behavioral Health Institute, University of Washington/UW Medicine, Seattle, WA USA
- Telepsychiatry, Psychiatry and Behavioral Sciences, University of Washington/UW Medicine, Seattle, WA USA
| | - Ingrid K. Wick
- Harborview Medical Center, Behavioral Health Institute, University of Washington/UW Medicine, Seattle, WA USA
| | - Melody McKee
- Workforce and Policy Innovation Center, Behavioral Health Training, University of Washington/UW Medicine, Seattle, WA USA
- Harborview Medical Center, Behavioral Health Institute, University of Washington/UW Medicine, Seattle, WA USA
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Teng K, Russo F, Kanuch S, Caron A. Virtual Care Adoption-Challenges and Opportunities From the Lens of Academic Primary Care Practitioners. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:599-602. [PMID: 36037465 PMCID: PMC9555588 DOI: 10.1097/phh.0000000000001548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Telehealth and virtual care quickly became important tools in caring for patients while the COVID-19 pandemic evolved. Telehealth implementation can increase affordability for patients, eliminate access barriers, and improve patient satisfaction. Multiple challenges to successful telehealth implementation have been documented in the literature and are generally categorized as structural barriers of the health system, clinical barriers of the provider, and patient-centered barriers. In this study, we sought to collect themes and observations about this rapid transition to telehealth from practicing primary care clinicians, with the goal of identifying opportunities to improve adoption of telehealth. Themes reported in this article emerged from physician and physician assistant fellows of 2 HRSA-funded grants: (1) Primary Care Training and Enhancement (PCTE) and (2) Primary Care Training and Enhancement Training Primary Care Champions (Champions). The PCTE participants consisted of 8 providers from The MetroHealth System (MHS). The Champions participants consisted of 20 providers from MHS and Federally Qualified Health Centers in Northeast Ohio and Michigan. Participants identified 5 major themes that affected telehealth delivery in an academic medical system: reimbursement and productivity; social determinants of health; privacy and environment of care concerns; teaching; and communication skills. Examples within each theme are provided along with an identified improvement opportunity. As we create solutions to address these challenges, our hope is to pool our experience with others so that we can collectively learn how to best evolve and improve the telehealth experience for all.
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Affiliation(s)
- Kathryn Teng
- Department of Medicine (Dr Teng), Population Health Research Institute (Ms Kanuch and Dr Caron), The MetroHealth System (Ms Russo), Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Francesca Russo
- Department of Medicine (Dr Teng), Population Health Research Institute (Ms Kanuch and Dr Caron), The MetroHealth System (Ms Russo), Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Stephanie Kanuch
- Department of Medicine (Dr Teng), Population Health Research Institute (Ms Kanuch and Dr Caron), The MetroHealth System (Ms Russo), Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Aleece Caron
- Department of Medicine (Dr Teng), Population Health Research Institute (Ms Kanuch and Dr Caron), The MetroHealth System (Ms Russo), Case Western Reserve University School of Medicine, Cleveland, Ohio
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11
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Powell KG, Chaple MJ, Henry M, Morton C, Becker SJ, Gotham HJ, Hagle HN, Helle AC, Krom LJ, Martin R, Molfenter TD, Roget N, Rutkowski BA, Velez-Echevarria II, Yanez R. Virtual training and technical assistance: a shift in behavioral health workforce access and perceptions of services during emergency restrictions. BMC MEDICAL EDUCATION 2022; 22:575. [PMID: 35897014 PMCID: PMC9326150 DOI: 10.1186/s12909-022-03598-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND To respond to the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration-funded Technology Transfer Centers had to rapidly adapt to ensure that the behavioral health workforce had continuous access to remote training and technical assistance (TTA). Although the Technology Transfer Centers have historically relied partially upon virtual methods for delivering TTA, the shift to a strictly virtual approach necessitated by COVID-19 restrictions has raised new questions for how to best proceed with services when social distancing guidelines are relaxed. The objective of this exploratory paper was to compare TTA provision in the six-month period prior to (9/1/19 thru 2/28/20) and during (4/1/20 thru 9/30/20) early COVID-19 restrictions to determine the extent to which the shift to virtual service provision impacted the behavioral health and medical workforce. Specifically, we examined participants' access to TTA, geographic reach of TTA, and workforce perceptions of satisfaction and utility with TTA provision. METHOD Participant and event-level data were analyzed to compare the following metrics before and during the COVID pandemic: number of events and attendees; participant demographics; zip codes reached; coverage of rural, suburban, and urban areas; and perceptions of satisfaction with and utility of training. RESULTS Findings showed a 40% increase in the number of events delivered (p < .001) and a 270% increase in the number of attendees (p < .001) during the COVID period when TTCs relied exclusively on virtual delivery. Geospatial analyses linking zip codes to a schematic of rural, suburban, and urban classifications throughout the United States revealed significant increases in the number of zip codes reached during the COVID time period. Satisfaction levels were comparable before and during the pandemic. CONCLUSIONS Findings show that expanded access to TTA services via virtual formats resulted in reach to more diverse attendees and regions, and did not come at the expense of satisfaction. Results suggest that virtual TTA should continue to be an important component of TTA offerings post-pandemic.
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Affiliation(s)
- Kristen G Powell
- Rutgers University School of Social Work, New Brunswick, NJ, USA.
| | | | - Maxine Henry
- National Latino Behavioral Health Association, Peña Blanca, NM, USA
| | - Cory Morton
- Rutgers University School of Social Work, New Brunswick, NJ, USA
| | - Sara J Becker
- Brown University School of Public Health, Providence, RI, USA
| | - Heather J Gotham
- Stanford University School of Medicine, Palo Alto, California, USA
| | - Holly N Hagle
- University of Missouri-Kansas City School of Nursing and Health Studies, Kansas City, MO, USA
| | - Ashley C Helle
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Laurie J Krom
- University of Missouri-Kansas City School of Nursing and Health Studies, Kansas City, MO, USA
| | | | | | - Nancy Roget
- University of Nevada, Reno, Reno, Nevada, USA
| | - Beth A Rutkowski
- UCLA Integrated Substance Abuse Programs, Los Angeles, California, USA
| | | | - Ruth Yanez
- National Latino Behavioral Health Association, Peña Blanca, NM, USA
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12
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Xiong Y, Huang R, Jiang J, Asempapa B, Fox S. Online Teaching Self-efficacy of Group Counseling Instructors during the COVID-19 Pandemic. Int J Group Psychother 2022; 72:228-256. [PMID: 38446561 DOI: 10.1080/00207284.2022.2081169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Due to the COVID-19 pandemic, many counseling-related programs switched to online teaching modalities. Group counseling instructors may face various challenges in teaching group counseling courses online. With a mixed-method design, this study explored group counseling instructors' online teaching self-efficacy by collecting survey responses from 39 group counseling instructors and interviewing eight instructors from the programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP). The instructors demonstrated a general high teaching self-efficacy with concerns about students' engagement. Facilitating and hindering factors related to online teaching self-efficacy are identified. Implications and recommendations for instructors, counseling-related programs, and the counseling profession are also discussed.
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Harding S, Eyllon M, Twigden A, Hogan A, Barry D, Mirsky J, Barnes B, Nordberg S. Power on: The rapid transition of a large interdisciplinary behavioral health department to telemental health during the COVID-19 pandemic. JOURNAL OF INTERPROFESSIONAL EDUCATION & PRACTICE 2022; 27:100506. [PMID: 35229056 PMCID: PMC8866964 DOI: 10.1016/j.xjep.2022.100506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/11/2022] [Accepted: 02/22/2022] [Indexed: 11/10/2022]
Abstract
Background The COVID-19 pandemic necessitated a rapid transition to telemental health (TMH) for behavioral health services in the behavioral health department of a large integrated primary care organization. Although the COVID-19 pandemic was the initial trigger for rapid organizational change, systems were developed with a focus on longer term scalability and sustainability. Methods This paper discusses the process of organizational change within our healthcare delivery system using the Strengths, Opportunities, Aspirations, and Results (SOAR) framework. Within this framework a structured mixed methods survey of 38 clinicians representing 5 different disciplines was conducted. Internal and survey data were analyzed to evaluate and guide the iterative change process. Results The majority of BH clinicians reported that they were as or more effective with TMH. The transition to TMH in our organization resulted in increased access to care, with a 10.3% increase in BH visit completions. The transition to TMH may benefit clinician work-life balance, but requires resources to support clinical, technological, and communication/teamwork changes. Implications/conclusions TMH is a feasible treatment modality for integrated care settings. It is cost-effective and well-accepted by clinicians. The SOAR framework can be used to guide rapid organizational change and ongoing QI processes.
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14
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Perle JG, Perle AR, Scarisbrick DM, Mahoney JJ. Educating for the Future: a Preliminary Investigation of Doctoral-Level Clinical Psychology Training Program's Implementation of Telehealth Education. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 7:351-357. [PMID: 35382354 PMCID: PMC8972773 DOI: 10.1007/s41347-022-00255-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/11/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022]
Abstract
Literature has reinforced the importance of telehealth-focused education to foster provider competence and optimal patient care. As clinical psychology evolves to meet field needs, many have suggested graduate school as an optimal time to offer comprehensive telehealth education. Despite the rapid expansion of telehealth post-COVID-19, the extent of telehealth-specific doctoral-level programming, as well as the foci of available trainings, has remained unclear. To address this gap and inform future work, the current study evaluated doctoral-level clinical psychology training programs throughout the USA. Fourteen doctoral-level training programs completed author-created REDCap-hosted demographic and telehealth training surveys. Pre-COVID-19, three of fourteen programs reported implementing some form of telehealth-focused education, with a majority of the information being viewed as optional targets for instructors. Contrastingly, thirteen programs indicated implementing telehealth-focused education post-COVID-19, with a majority of the information being indicated as mandatory educational targets. Despite increases in educational activities, a large number of programs endorsed a desire for additional telehealth-focused education for students as they transition into future roles. Educational foci, methods of training, and instructor preparation are discussed. While participation was limited, the current study demonstrated positive trends in the development of telehealth-focused education. Nevertheless, there remains an ongoing need for both specialized coursework and a wider range of educational topics. Ultimately, the current study is believed to have provided a preliminary evaluation of the types and foci of telehealth-focused education among doctoral-level clinical psychology training programs.
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Affiliation(s)
- Jonathan G. Perle
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, WV USA
| | - Alexandria R. Perle
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, WV USA
| | - David M. Scarisbrick
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, WV USA
- Department of Neuroscience, West Virginia University, Morgantown, WV USA
| | - James J. Mahoney
- Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Rockefeller Neuroscience Institute, Morgantown, WV USA
- Department of Neuroscience, West Virginia University, Morgantown, WV USA
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15
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Sculley JA, Musick H, Krishnan JA. Telehealth in chronic obstructive pulmonary disease: before, during, and after the coronavirus disease 2019 pandemic. Curr Opin Pulm Med 2022; 28:93-98. [PMID: 34860202 PMCID: PMC8815630 DOI: 10.1097/mcp.0000000000000851] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Many healthcare systems rapidly implemented telehealth as a substitute for in-person care during the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this review is to describe the evidence base supporting the use of telehealth for chronic obstructive pulmonary disease (COPD) prior to the COVID-19 pandemic, discuss the barriers to implementing telehealth during the pandemic, and share our opinion about the future of telehealth in COPD. RECENT FINDINGS The evidence from randomized clinical trials in COPD completed prior to the COVID-19 pandemic indicate that the effectiveness of telehealth interventions compared to in-person usual care on clinical outcomes is inconclusive. Recent experience during the COVID-19 pandemic indicates that telehealth may increase access to healthcare and satisfaction with care when delivered in addition to usual in-person care. While some reimbursement-related barriers to telehealth have been alleviated during the COVID-19 pandemic, several patient, provider, and health-system barriers to implementation remain. SUMMARY There is a need to further evaluate the delivery of telehealth services as an adjunct to traditional in-person models of COPD care. Standardization and reporting of core clinical, satisfaction, accessibility, and quality of care outcomes are needed to promote cross-study learning and more rapid translation of research evidence into practice.
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16
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Frye WS, Feldman M, Katzenstein J, Gardner L. Modified Training Experiences for Psychology Interns and Fellows During COVID-19: Use of Telepsychology and Telesupervision by Child and Adolescent Training Programs. J Clin Psychol Med Settings 2022; 29:840-848. [PMID: 35083617 PMCID: PMC8791679 DOI: 10.1007/s10880-021-09839-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 01/01/2023]
Abstract
Coronavirus (COVID-19) has affected opportunities available to psychology interns and postdoctoral fellows completing capstone training experiences during culminating training years. While research supports COVID-19 has increased the use of telepsychology services amongst psychologists, there is a paucity of research regarding how COVID-19 has altered training and use of telepsychology by psychology trainees. The current study includes survey responses from 59 psychology training directors and 58 psychology internship and postdoctoral fellowship trainees at pediatric sites throughout the United States. Results support changes in telepsychology training provided during COVID-19, including increased use of telepsychology for clinical service delivery and increased use of telesupervision for training. As expected, findings suggest novel training experiences in telepsychology for trainees within the last two years as a result of COVID-19. Given ongoing need for telepsychology services to assure access to psychological care during the pandemic and beyond, results provide support for graduate and advanced training programs to provide formal training in best-practices for utilization of telepsychology and telesupervision.
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Affiliation(s)
- William S Frye
- Psychology Department, Johns Hopkins All Children's Hospital, 880 6th Street South, Suite 420, St. Petersburg, FL, 33701, USA.
| | - Marissa Feldman
- Psychology Department, Johns Hopkins All Children's Hospital, 880 6th Street South, Suite 420, St. Petersburg, FL, 33701, USA
| | - Jennifer Katzenstein
- Psychology Department, Johns Hopkins All Children's Hospital, 880 6th Street South, Suite 420, St. Petersburg, FL, 33701, USA
| | - Lauren Gardner
- Psychology Department, Johns Hopkins All Children's Hospital, 880 6th Street South, Suite 420, St. Petersburg, FL, 33701, USA
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17
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DuBose-Morris R, Coleman C, Ziniel SI, Schinasi DA, McSwain SD. Telehealth Utilization in Response to the COVID-19 Pandemic: Current State of Medical Provider Training. Telemed J E Health 2021; 28:1178-1185. [PMID: 34967677 PMCID: PMC9398486 DOI: 10.1089/tmj.2021.0381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background: The COVID-19 pandemic accelerated the development of telehealth services and thus the need for telehealth education and training to support rapid implementation at scale. A national survey evaluating the current state of the telehealth landscape was deployed to organizational representatives, and included questions related to education and training. Materials and Methods: In the summer of 2020, 71 survey participants (31.8%) completed an online survey seeking to determine the utilization of telehealth services across institutional types and locations. This included data collected to specifically compare the rates and types of formal telehealth education provided before and during the pandemic. Results: Thirty percent of organizations reported no telehealth training before COVID-19, with those in suburban/rural settings significantly less likely to provide any training (55% vs. 82%) compared with urban. Pandemic-related training changes applied to 78% of organizations, with more change happening to those without any training before COVID-19 (95%). Generally, organizations offering training before the pandemic reported deploying COVID-19-related telehealth services, while a higher percentage of those without any training beforehand reported that they either did not plan on providing these services or were in the early planning stages. Discussion: Telehealth education is moving from elective to essential based on the need to prepare and certify the workforce to support high-quality telehealth services. Conclusions: As telehealth continues to evolve to meet the future health care service needs of patients and providers, education and training will advance to meet the needs of everyday clinical encounters and broader public health initiatives.
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Affiliation(s)
- Ragan DuBose-Morris
- Center for Telehealth, Center of Excellence, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Christina Coleman
- Pediatrics Critical Care, College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Sonja I Ziniel
- Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA.,Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Dana A Schinasi
- Telehealth Programs, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - S David McSwain
- Pediatric Critical Care Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
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18
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Traube D, Gozalians S, Duan L. Transitions to virtual early childhood home visitation during COVID-19. Infant Ment Health J 2021; 43:69-81. [PMID: 34953079 PMCID: PMC9015548 DOI: 10.1002/imhj.21957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 12/01/2021] [Indexed: 11/09/2022]
Abstract
COVID-19 has disrupted many of the preventive service sectors designed to promote infant mental health. The purpose of this study is to examine provider and supervisor transition strategies as well as maternal-child outcomes during the transition from in-person to virtual early childhood home visitation services in Los Angeles County. Los Angeles County is one of the largest home visitation sectors in the U.S. and disproportionately impacted by the COVID-19 pandemic. Transitioning from in-person to virtual home visitation was an important step in ensuring the continuity of infant mental health services. Home visitors reported relative ease in transitioning to virtual services themselves but noted that families encountered greater difficulty. The most helpful strategies to support this transition included training, ongoing reflective supervision, and provision of technology. Family level analysis revealed that positive screening rates for anxiety and depression decreased during the pandemic as did referrals for most support services. These findings likely highlight challenges in delivering virtual home visitation. Understanding how transitions in a key infant serving sector were managed serves an important role in forecasting for the future and preparing for future public heath emergencies.
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Affiliation(s)
- Dorian Traube
- USC Dworak-Peck School of Social Work, Los Angeles, California, USA
| | - Sharlene Gozalians
- Los Angeles Best Babies Network at Dignity Health California Hospital Medical Center, Los Angeles, California, USA
| | - Lei Duan
- USC Dworak-Peck School of Social Work, Los Angeles, California, USA
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19
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Emmons RP, Harris IM, Abdalla M, Afolabi TM, Barner AE, Baxter MV, Bisada M, Chase AM, Christenberry EJ, Cobb BT, Dang Y, Hickman CM, Mills AR, Wease H. Impact of remote delivery of clinical pharmacy services on health disparities and access to care. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Ila M. Harris
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Maha Abdalla
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | | | | | - Miriam Bisada
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | | | | | - Yen Dang
- American College of Clinical Pharmacy Lenexa Kansas USA
| | | | - Alex R. Mills
- American College of Clinical Pharmacy Lenexa Kansas USA
| | - Heather Wease
- American College of Clinical Pharmacy Lenexa Kansas USA
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20
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Tabak RG, Schwarz CD, Kemner A, Johnston S, Aramburu A, Haire-Joshu D. Social Determinants of Health Discussed with Mothers During Personal Visits Before and During the COVID-19 Pandemic. Health Equity 2021; 5:536-544. [PMID: 34909520 PMCID: PMC8665790 DOI: 10.1089/heq.2020.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/12/2022] Open
Abstract
Purpose: This report describes the social determinants of health (SDOH) discussed during personal visits at the time leading up to and during the first 4 months of the pandemic from families across the United States. Methods: This is a secondary analysis from a cluster randomized trial that embeds Healthy Eating and Active Living Taught at Home within Parents as Teachers (PAT). PAT is a national organization serving families prenatal through kindergarten, delivered by parent educators. After parent educators complete visits with mothers in the trial, they complete brief surveys including the question "Did issues with any of these come up during the visit?" with yes/no options for "Transportation," "Housing," "Food insecurity," "Childcare," "Financial constraint," or "Other." Results: Among the 60 mothers with visit records in the months before and during (March-July 2020) COVID-19, 55% identified as Hispanic or Latino and 52% reported food insecurity at baseline. During COVID-19, financial constraints and other SDOH were as common as they were before COVID-19; childcare issues were discussed less frequently and food security was discussed more frequently. When comparing the number of SDOH parent educators reported discussing with mothers in visits that took place before COVID-19 with the number of SDOH discussed in visits during COVID-19, the number of SDOH increased for 41% for mothers identifying as Hispanic or Latino and only 8% for non-Hispanic or Latino mothers. Conclusions: This study can help build an understanding of how COVID-19 is impacting families, and how these impacts may be inequitable. Clinical Trial Registration Number: NCT03758638.
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Affiliation(s)
- Rachel G. Tabak
- Center for Diabetes Translation Research, Washington University in St. Louis Brown School, St. Louis, Missouri, USA
| | - Cynthia D. Schwarz
- Center for Diabetes Translation Research, Washington University in St. Louis Brown School, St. Louis, Missouri, USA
| | - Allison Kemner
- Parents as Teachers National Center, St. Louis, Missouri, USA
| | - Shelly Johnston
- Center for Diabetes Translation Research, Washington University in St. Louis Brown School, St. Louis, Missouri, USA
| | - Adriana Aramburu
- Center for Diabetes Translation Research, Washington University in St. Louis Brown School, St. Louis, Missouri, USA
| | - Debra Haire-Joshu
- Center for Diabetes Translation Research, Washington University in St. Louis Brown School, St. Louis, Missouri, USA
- Department of Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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21
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Kroll K, Brosig C, Malkoff A, Bice-Urbach B. Evaluation of a Systems-Wide Telebehavioral Health Training Implementation in Response to COVID-19. J Patient Exp 2021; 8:2374373521997739. [PMID: 34179392 PMCID: PMC8205362 DOI: 10.1177/2374373521997739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
In response to the Coronavirus disease 2019 pandemic, it became important to rapidly train mental health providers to provide telebehavioral health services (TBH) within a pediatric care setting. This study examined the perceived usefulness of various TBH training materials; provider motivation, comfort, and confidence in implementation of TBH services; and perceived benefits and barriers of TBH. After completing various training options and implementing TBH services for 1 month, providers indicated all training materials were helpful, with the recorded webinar being identified as the most helpful resource. This study describes the rapid training of mental health providers in preparation of system-wide TBH services.
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Affiliation(s)
- Kristin Kroll
- Department of Pediatrics, Medical College of Wisconsin, and Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI, USA
| | - Cheryl Brosig
- Department of Pediatrics, Medical College of Wisconsin, and Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI, USA
| | - Anne Malkoff
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Brittany Bice-Urbach
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
- Brittany Bice-Urbach, Children’s Wisconsin, Child Development Center, 13800 W. North Ave Ste 120, Brookfield, WI 53205, USA.
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22
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Garcia D, Blizzard AM, Peskin A, Rothenberg WA, Schmidt E, Piscitello J, Espinosa N, Salem H, Rodriguez GM, Sherman JA, Parlade MV, Landa AL, Davis EM, Weinstein A, Garcia A, Perez C, Rivera JM, Martinez C, Jent JF. Rapid, Full-Scale Change to Virtual PCIT During the COVID-19 Pandemic: Implementation and Clinical Implications. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:269-283. [PMID: 33586056 PMCID: PMC7882248 DOI: 10.1007/s11121-021-01211-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 11/20/2022]
Abstract
Health agencies call for the immediate mobilization of existing interventions in response to numerous child and family mental health concerns that have arisen as result of the COVID-19 pandemic. Answering this call, this pilot study describes the rapid, full-scale change from a primarily clinic-based Parent–Child Interaction Therapy (PCIT) model to a virtual service model (i.e., I-PCIT) in an academic and community-based program in Miami, Florida. First, we describe the virtual service training model our program developed and its implementation with 17 therapists (MAge = 32.35, 88.2% female, 47.1% Hispanic) to enable our clinic to shift from providing virtual services to a small portion of the families served (29.1%) to all of the families served. Second, we examine the effect of I-PCIT on child and caregiver outcomes during the 2-month stay-at-home period between March 16, 2020, and May 16, 2020, in 86 families (MChildAge = 4.75, 71% Hispanic). Due to the rapid nature of the current study, all active participants were transferred to virtual services, and therefore there was no comparison or control group, and outcomes represent the most recently available scores and not treatment completion. Results reveal that I-PCIT reduced child externalizing and internalizing problems and caregiver stress, and increased parenting skills and child compliance with medium to large effects even in the midst of the COVID-19 pandemic. Finally, the study examined components of our virtual service training model associated with the greatest improvements in child and caregiver outcomes. Preliminary findings revealed that locally and collaboratively developed strategies (e.g., online communities of practice, training videos and guides) had the strongest association with child and caregiver outcomes. Implications for virtual service delivery, implementation, and practice in the midst of the COVID-19 pandemic are discussed.
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Affiliation(s)
- Dainelys Garcia
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA.
| | - Angela M Blizzard
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Abigail Peskin
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - W Andrew Rothenberg
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA.,Duke University Center for Child and Family Policy, Coral Gables, 33146, USA
| | - Ellyn Schmidt
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Jennifer Piscitello
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Natalie Espinosa
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Hanan Salem
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Gabriela M Rodriguez
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, 46202, USA
| | - Jamie A Sherman
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Meaghan V Parlade
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Alexis L Landa
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Eileen M Davis
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Allison Weinstein
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Angela Garcia
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Camille Perez
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Jessica M Rivera
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Chary Martinez
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
| | - Jason F Jent
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, 33137, USA
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23
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Hassani K, McElroy T, Coop M, Pellegrin J, Wu WL, Janke RD, Johnson LK. Rapid Implementation and Evaluation of Virtual Health Training in a Subspecialty Hospital in British Columbia, in Response to the COVID-19 Pandemic. Front Pediatr 2021; 9:638070. [PMID: 34095023 PMCID: PMC8171666 DOI: 10.3389/fped.2021.638070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 04/06/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction: Adoption of virtual health (VH) solutions in healthcare has been challenging; this changed rapidly after implementation of physical distancing measures due to the COVID-19 pandemic. In response to the pandemic, British Columbia's Children's and Women's sub-specialty hospitals rapidly trained and scaled up support to equip staff and clinicians to use VH. Methods: Ninety-minute live online training workshops and frequently updated online support materials were offered for 6 weeks. Training was monitored via feedback collected at training sessions and a brief post-training survey. After training completion, a second survey was circulated to measure utilization outcomes and experiences with VH. Results: Eight hundred and ninety-five participants representing 82% of staff requiring support were trained through 101 sessions; 348 (38.9%) and 272 (30.4%) responses were collected for the monitoring and outcome surveys, respectively. Overall, 89% agreed that training was relevant to their needs; participants indicated average 58.1% (SD = 26.6) and 60.6% (SD = 25.2) increase in knowledge and confidence in VH after training; 90.1% had booked or conducted VH sessions. Increase in confidence was more pronounced in participants with lesser previous exposure to VH, but number of sessions conducted post-training and percentage of successful sessions were independent of previous exposure. For future training and support, participants suggested subject-tailored trainings, asynchronous trainings, and availability of experienced users. Discussion: Training is key to success of VH implementation. Moving forward, core competencies in VH should be developed to support standardization and allow for evaluation and quality improvement. Incorporation of VH training in continuous professional development and onboarding is also highly recommended.
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Affiliation(s)
- Kasra Hassani
- Child Health British Columbia (BC), Provincial Health Services Authority, Vancouver, BC, Canada
| | - Theresa McElroy
- Child Health British Columbia (BC), Provincial Health Services Authority, Vancouver, BC, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Melissa Coop
- Child Health British Columbia (BC), Provincial Health Services Authority, Vancouver, BC, Canada
| | - Joelle Pellegrin
- Child Health British Columbia (BC), Provincial Health Services Authority, Vancouver, BC, Canada
| | - Wan Ling Wu
- Child Health British Columbia (BC), Provincial Health Services Authority, Vancouver, BC, Canada
| | - Rita D Janke
- Child Health British Columbia (BC), Provincial Health Services Authority, Vancouver, BC, Canada
| | - L Kit Johnson
- Child Health British Columbia (BC), Provincial Health Services Authority, Vancouver, BC, Canada
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24
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Abstract
Purpose
There are growing expectations that students graduating from health courses and current health professionals have some proficiency in using telehealth. However, there is limited accessibility to multidisciplinary-based material to meet this need. This paper describes the development of an online telehealth education resource using a co-design approach and the strengths and challenges of embedding authentic learning principles in an open-access online course with a broad target audience.
Design/methodology/approach
The authors first describe the co-design process of the course and discuss the pedagogy underpinning the course design. Then learner enrolment data is discussed to evidence uptake across key characteristics. Finally, the authors assess the efficacy of the co-design approach by analysing feedback collected from learners at the end of the course.
Findings
The course is structured across four modules and comprises interactive content, reflective tasks, case studies and purposefully developed digital material. Responses from the working group and from learner feedback indicate that the course is an authentic and relevant introduction to telehealth practice for both health students and current health professionals, despite some limitations.
Originality/value
This case study demonstrates the value of a co-design process and key learning design choices in online course development to meet the educational needs of learners from broad disciplinary backgrounds, in various stages of learning/understanding of telehealth and/or requiring a practice-based resource in the context of a rapidly changing policy environment.
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