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Johnson EA, Strauch KA. A mixed-methods pilot examination of Montana, North Dakota nurse practitioner telepresence behaviors through web-camera eye-tracking and qualitative descriptive interviews. J Am Assoc Nurse Pract 2024; 36:270-278. [PMID: 37917096 DOI: 10.1097/jxx.0000000000000974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND The use of telehealth for mental health-related encounters has increased exponentially since the COVID-19 pandemic. However, little is known how nurse practitioners (NPs) in rural areas establish connection and presence with patients through telehealth. PURPOSE To leverage web-camera eye-tracking technology coupled with qualitative interviews to better understand rural NPs' perceptions, beliefs, experiences, and visual cues of connection and presence during mental health-related telehealth encounters. METHODS This mixed-methods study employed web-camera eye-tracking technology to measure eye contact, facial/body movements with microexpressions, and auditory expressions during a simulated mental health-related telehealth visit. A qualitative descriptive methodology was used to conduct semistructured interviews with participants regarding utilization of telehealth in rural mental health care delivery. Sticky software, R, and STATA were used for the quantitative eye-tracking and demographic data analyses. Qualitative findings were analyzed using inductive thematic analysis. RESULTS Ten NPs participated in the eye-tracking aspect of the study; among them, three completed semistructured interviews. Eye-tracking areas of interest were significant for the number of fixations ( p = .005); number of visits ( p < .001); time until notice ( p < .001); and time viewed ( p < .001). The category Workflow had the greatest number of thematic units ( n = 21) derived from semistructured interviews. CONCLUSIONS Although an accessible means of obtaining data, web-camera eye tracking poses challenges with data usability. This prompts further attention to research, optimizing the telehealth milieu to lessen patient and provider frustrations with technological or environmental issues. IMPLICATIONS Nurse practitioners provide a key voice in the design and deployment of telehealth platforms congruent with the comprehensive assessment and presence of remote care delivery.
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Affiliation(s)
- Elizabeth A Johnson
- Mark & Robyn Jones College of Nursing, Montana State University, Bozeman, Montana
| | - Kimberly A Strauch
- Leonard A. Lauder Community Care Nurse Practitioner Program, The University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania
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2
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Burstin H, Clark KJ, Duff N, Dopp AL, Bentley E, Wattenberg S, Sandbrink F, Beale RR, Ling SM, Eaton E, Freiling E, Salman A. Integrating Telehealth and Traditional Care in Chronic Pain Management and Substance Use Disorder Treatment: An Action Agenda for Building the Future State of Hybrid Care. NAM Perspect 2023; 2023:202310b. [PMID: 38784634 PMCID: PMC11114598 DOI: 10.31478/202310b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
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3
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Anil K, Bird AR, Bridgman K, Erickson S, Freeman J, McKinstry C, Robinson C, Abey S. Telehealth competencies for allied health professionals: A scoping review. J Telemed Telecare 2023:1357633X231201877. [PMID: 37787172 DOI: 10.1177/1357633x231201877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
INTRODUCTION Telehealth has become one of the main methods of delivering allied health professional services world-wide, yet many professionals do not have sufficient training to deliver high-quality telehealth services. This review aims to identify what competencies allied health professionals require for effective telehealth service delivery. METHODS This scoping review used the Population Concept Context framework and searched the following databases: MEDLINE, CINAHL, PsychInfo, Cochrane, EMBASE, Web of Science, PEDro, United Kingdom Health Forum, WHO, Health Education England, and all UK and Australian AHP professional bodies. RESULTS A total of 37 articles were included out of 92,525 identified by the literature search. Competencies were related to two areas: (1) delivery of the telehealth consultation and (2) service management of telehealth consultations. The first area included the following competency themes: clinical reasoning, communication, effectively using technology, person-centred care, practice-based assessment and intervention knowledge/behaviour/skills, privacy, security, and patient safety, professionalism, and setting up the technical environment. The second area included the following competency themes: digital infrastructure, informing practice, and management. Although findings emphasised the importance of telehealth competencies, none have been implemented within education. One-third of the articles were from the discipline of psychology. CONCLUSION This is the first scoping review to combine telehealth competencies reported across allied health disciplines. Although there were a vast range of competencies, they need implementation into teaching and learning to be practically useful. Most competencies were from psychology, but potentially applicable for other allied health professionals. A shared and adaptable standard for telehealth competencies would be useful to ensure high-quality practice across all allied health professionals.
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Affiliation(s)
- Krithika Anil
- School of Health Professions, University of Plymouth, UK
| | - Adam R Bird
- School of Allied Health, Human Services & Sport, La Trobe University, Melbourne, VIC, Australia
| | - Kate Bridgman
- School of Allied Health, Human Services & Sport, La Trobe University, Melbourne, VIC, Australia
| | - Shane Erickson
- School of Allied Health, Human Services & Sport, La Trobe University, Melbourne, VIC, Australia
| | | | - Carol McKinstry
- School of Allied Health, Human Services & Sport, La Trobe University, Melbourne, VIC, Australia
| | | | - Sally Abey
- School of Health Professions, University of Plymouth, UK
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4
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Tomlinson SRL, Gore N, McGill P. Family carer and professional perceptions of the potential use of telehealth for behavioural support. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:531-546. [PMID: 36919000 DOI: 10.1111/jir.13026] [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: 08/24/2022] [Revised: 01/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Telehealth (i.e. the use of technology across distance) is widespread in many fields. Although its use for behavioural support for people with intellectual or developmental disabilities (IDD) is emerging, there are no known studies examining stakeholder perceptions of this. METHODS A four-round Delphi consultation was conducted with 11 professionals and six family carers of children with IDD to generate consensus on what would influence participants' use of telehealth for behavioural support. Data were collected prior to the coronavirus pandemic. RESULTS Thirty-six items reached consensus for professionals (26 advantages and 10 disadvantages/barriers) and 22 for family carers (8 advantages and 14 disadvantages/barriers). A range of solutions were also identified for the disadvantages/barriers. CONCLUSIONS Participants were willing to use telehealth for behavioural support. However, disadvantages/barriers need to be addressed, and guidelines relating to the use of telehealth in this field are needed. We report a number of practice recommendations including combining telehealth with in-person supports where possible, incorporating video technologies, and considering client perspectives and confidence with telehealth methodologies.
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Affiliation(s)
| | - N Gore
- Tizard Centre, University of Kent, Canterbury, UK
| | - P McGill
- Tizard Centre, University of Kent, Canterbury, UK
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5
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Bergvall H, Larsson C, Strålin EE, Bohman B, Alfonsson S. Perceived effects of the COVID-19 pandemic on clinical psychology internships in Sweden. BMC MEDICAL EDUCATION 2023; 23:249. [PMID: 37069581 PMCID: PMC10106869 DOI: 10.1186/s12909-023-04236-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The COVID-19 pandemic has had an unprecedented impact on societies and health care services worldwide, including the clinical training of psychology interns. Some of the pandemic-related restrictions were in breach of the internship requirements, increasing the risk of failed internships and a shortage of new health care professionals. This situation needed to be assessed. METHODS Web-based surveys were administered to clinical psychology interns in Sweden 2020 (n = 267) and 2021 (n = 340), as well as to supervisors in 2020 (n = 240). The supervisors also provided information about their interns (n = 297). RESULTS Risk factors for a prolonged internship, such as pandemic-related absence from work (12.4% in 2020 and 7.9% in 2021), unqualified work (0% in 2020, 3% in 2021), and change in internship content were low. However, remote interactions using digital services increased. Face-to-face patient contacts decreased significantly from 2020 to 2021 (Χ2 = 5.17, p = .023), while remote work and remote supervision increased significantly (Χ2 = 53.86, p < .001 and Χ2 = 8.88, p = .003, respectively). Still, the content in patient contacts and supervision was maintained. Most interns reported no difficulties with remote supervision or supervision in personal protective equipment. However, of the interns who reported difficulties, role-play and skills training in remote supervision were perceived as significantly harder (Χ2 = 28.67, p < .001) than in supervision using personal protective equipment. CONCLUSIONS The present study indicates that clinical training of psychology interns in Sweden could proceed despite a societal crisis. Results suggest that the psychology internship was flexible in the sense that it could be realized in combined face-to-face and remote formats without losing much of its value. However, the results also suggest that some skills may be harder to train in remote supervision.
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Affiliation(s)
- Hillevi Bergvall
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Cornelia Larsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Elinor Eskilsson Strålin
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Benjamin Bohman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sven Alfonsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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6
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Palmer CS, Brown Levey SM, Kostiuk M, Zisner AR, Tolle LW, Richey RM, Callan S. Virtual Care for Behavioral Health Conditions. Prim Care 2022; 49:641-657. [PMID: 36357068 PMCID: PMC9581698 DOI: 10.1016/j.pop.2022.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Christina S. Palmer
- Department of Family Medicine, University of Colorado School of Medicine,Corresponding author
| | | | | | - Aimee R. Zisner
- Department of Family Medicine, University of Colorado School of Medicine
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Batton B, Kaplan R, Ellis K, Schmidt C, Nudelman E. Telehealth Training in Principles of Applied Behavior Analysis for Caregivers of Young Children with Autism Spectrum Disorders during the COVID-19 Pandemic. EDUCATION & TREATMENT OF CHILDREN 2022; 45:299-303. [PMID: 35936026 PMCID: PMC9345387 DOI: 10.1007/s43494-022-00081-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
Following the outbreak of the COVID-19 pandemic, the U.S. government declared a state of emergency and many applied behavior analysis clinics temporarily closed. The current study described a pilot of an existing manualized caregiver behavior skills training, the Online and Applied System of Intervention Skills (OASIS), to promote telehealth caregiver training during the pandemic and facilitate the start of early intervention for families on waitlists. The OASIS telehealth curriculum trains caregivers to use applied behavior analysis with their children with autism spectrum disorder. Pre/post measures suggest that OASIS modestly improved parent knowledge, improved perceived quality of life, decreased stress, improved caregiver self-efficacy, and was viewed positively by participating families.
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Affiliation(s)
| | | | - Kaci Ellis
- University of Florida, Gainesville, FL USA
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Ruppel PR, Juanico JF, Johnson KLD. The Effects of Remote Instructions, Rehearsal, and Feedback on Preference Assessment Implementation. JOURNAL OF ORGANIZATIONAL BEHAVIOR MANAGEMENT 2022. [DOI: 10.1080/01608061.2022.2078455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Paula R. Ruppel
- University of Kansas, Department of Applied Behavioral Science, Lawrence, Kansas, USA
| | - Jessica F. Juanico
- University of Kansas, Department of Applied Behavioral Science, Lawrence, Kansas, USA
| | - Kayt-Lyn D. Johnson
- University of Kansas, Department of Applied Behavioral Science, Lawrence, Kansas, USA
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Kreysa H, Schneider D, Kowallik AE, Dastgheib SS, Doğdu C, Kühn G, Ruttloff JM, Schweinberger SR. Psychosocial and Behavioral Effects of the COVID-19 Pandemic on Children and Adolescents with Autism and Their Families: Overview of the Literature and Initial Data from a Multinational Online Survey. Healthcare (Basel) 2022; 10:healthcare10040714. [PMID: 35455891 PMCID: PMC9028372 DOI: 10.3390/healthcare10040714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 02/04/2023] Open
Abstract
Since COVID-19 has become a pandemic, everyday life has seen dramatic changes affecting individuals, families, and children with and without autism. Among other things, these changes entail more time at home, digital forms of communication, school closures, and reduced support and intervention. Here, we assess the effects of the pandemic on quality of life for school-age autistic and neurotypical children and adolescents. First, we provide a comprehensive review of the current relevant literature. Next, we report original data from a survey conducted in several countries, assessing activities, well-being, and social life in families with autism, and their changes over time. We focus on differences between children with and without autism from within the same families, and on different outcomes for children with high- or low-functioning autism. While individuals with autism scored lower in emotional and social functioning than their neurotypical siblings, both groups of children showed comparable decreases in well-being and increases in anxiety, compared to before the pandemic. By contrast, decreases in adaptability were significantly more pronounced in autistic children and adolescents compared to neurotypical children and adolescents. Overall, although individual families reported some positive effects of pandemic restrictions, our data provide no evidence that these generalize across children and adolescents with autism, or even just to individuals with high-functioning autism. We discuss the increased challenges that need to be addressed to protect children and adolescents’ well-being under pandemic conditions, but also point out potentials in the present situation that could be used towards social participation and success in older children and young adults with autism.
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Affiliation(s)
- Helene Kreysa
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
- Correspondence: (H.K.); (S.R.S.)
| | - Dana Schneider
- Social Potential in Autism Research Unit & Department of Social Psychology, Friedrich Schiller University Jena, 07743 Jena, Germany; (D.S.); (C.D.)
- DFG Scientific Network “Understanding Others”, SCHN 1481/2-1, 10117 Berlin, Germany
| | - Andrea Erika Kowallik
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
- Early Support and Counseling Center Jena, Herbert Feuchte Stiftungsverbund, 07743 Jena, Germany;
- Department of Psychiatry, Jena University Hospital, 07743 Jena, Germany
| | - Samaneh Sadat Dastgheib
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
| | - Cem Doğdu
- Social Potential in Autism Research Unit & Department of Social Psychology, Friedrich Schiller University Jena, 07743 Jena, Germany; (D.S.); (C.D.)
| | - Gabriele Kühn
- Early Support and Counseling Center Jena, Herbert Feuchte Stiftungsverbund, 07743 Jena, Germany;
| | - Jenny Marianne Ruttloff
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
| | - Stefan R. Schweinberger
- Social Potential in Autism Research Unit & Department of General Psychology and Cognitive Neuroscience, Friedrich Schiller University Jena, 07743 Jena, Germany; (A.E.K.); (S.S.D.); (J.M.R.)
- Correspondence: (H.K.); (S.R.S.)
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10
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Jones E, Kurman J, Delia E, Crockett J, Peterson R, Thames J, Salorio C, Kalb L, Jacobson L, Stone J, Zabel TA. Parent Satisfaction With Outpatient Telemedicine Services During the COVID-19 Pandemic: A Repeated Cross-Sectional Study. Front Pediatr 2022; 10:908337. [PMID: 36090558 PMCID: PMC9453196 DOI: 10.3389/fped.2022.908337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
Prior to the COVID-19 pandemic, the development of hospital-based telemedicine services had been slow and circumscribed in scope due to insurance and licensure restrictions. As these restrictions were eased during the COVID-19 pandemic to facilitate ongoing patient care, the public health emergency facilitated a rapid expansion and utilization of telemedicine services across the ambulatory service sector. Objectives The current quality improvement (QI) study utilized this unprecedented opportunity to evaluate the use of telemedicine services across a variety of clinical disciplines and patient groups. Methods Caregivers of patients (ages 0-21) who received care through an outpatient specialty center provided experience ratings of telemedicine services delivered during the initial pandemic months (March-June 2020; N = 1311) or during the national "winter surge" in late 2020 (November 2020-February 2021; N = 1395). Questionnaires were distributed electronically following the clinical visits, and ANCOVA was employed (with patient age as the covariate) to determine if caregiver responses differed based on patient demographic characteristics. Results Ratings of patient satisfaction with services were very strong at both time points; greater variability in scores was noted when caregivers were asked if they would use telemedicine services again. At both time points, younger patient age (i.e., age 0-5) was associated with decreased caregiver willingness to use telemedicine services in the future. Smaller effects were seen for certain "hands on" therapies (occupational, physical, and speech) during the initial months of the pandemic and for proximity to the hospital during the "winter surge." Conclusions These data suggest a very positive overall caregiver response to telemedicine-based services during the COVID-19 pandemic. Several areas of potential improvement/innovation were identified, including the delivery of telemedicine therapies (e.g., occupational, physical, and speech) services to young patients (i.e., aged 0-5).
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Affiliation(s)
- Erin Jones
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Jaime Kurman
- Office of Patient Experience and Community Engagement, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Elisa Delia
- Administration, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Jennifer Crockett
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States.,Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Rachel Peterson
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States.,Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jasmin Thames
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Cynthia Salorio
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States.,Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Luther Kalb
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, United States.,Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Lisa Jacobson
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States.,Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Jacqueline Stone
- Administration, Kennedy Krieger Institute, Baltimore, MD, United States.,Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - T Andrew Zabel
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States.,Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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11
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Srinivasan SM, Su WC, Cleffi C, Bhat AN. From Social Distancing to Social Connections: Insights From the Delivery of a Clinician-Caregiver Co-mediated Telehealth-Based Intervention in Young Children With Autism Spectrum Disorder. Front Psychiatry 2021; 12:700247. [PMID: 34276452 PMCID: PMC8280343 DOI: 10.3389/fpsyt.2021.700247] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/07/2021] [Indexed: 12/11/2022] Open
Affiliation(s)
- Sudha M. Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Mansfield, CT, United States
| | - Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Corina Cleffi
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Anjana N. Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological and Brain Science, University of Delaware, Newark, DE, United States
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12
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Oblak MK. An analysis of a system under pandemic conditions. J Appl Behav Anal 2021; 54:530-546. [PMID: 33817789 DOI: 10.1002/jaba.836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 01/05/2023]
Abstract
Recent events have emphasized the need for behavior-analytic service delivery models that can remain clinically consistent and produce high-quality outcomes while adapting to environmental change. This paper reports outcomes of an organization that adapted to changes in its service delivery model during a worldwide pandemic. The organization utilized components from the Comprehensive Application of Behavior Analysis to Schooling (CABAS®) model. The components were interconnected within the system and linked by specific interlocking contingencies. Performance data were used to make decisions within the organization on both individual and organizational levels during the transition to telehealth for clients and staff. Results are discussed in terms of how the interconnectedness of components within the organization contributed to the reliable, positive outcomes of the system during the transition to telehealth.
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13
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Shawler LA, Clayborne JC, Nasca B, O'Connor JT. An intensive telehealth assessment and treatment model for an adult with developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 111:103876. [PMID: 33524736 DOI: 10.1016/j.ridd.2021.103876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
Over the last decade, the provision of applied behavior analysis (ABA) services within a telehealth delivery format has had a flourishing literature base. Research has demonstrated that caregivers can successfully conduct functional analyses and functional communication training to treat challenging behavior with coaching from practitioners via telehealth. Previous limitations include research that has only been conducted with children, typically in 1hr, weekly meetings, so the utility of providing ABA therapy via telehealth across the lifespan is unknown. Additionally, the effects of a more intensive treatment format delivered via telehealth has not been evaluated. The purpose of the current study was to coach caregivers to conduct the assessment and treatment process for a young man with developmental disabilities using an intensive-outpatient model in a telehealth format. Functional analysis procedures led to the development of a function-based treatment to reduce challenging behavior and increase functional communication. Caregivers demonstrated high procedural integrity across all phases of the study and found the intervention highly acceptable and effective. Areas for future research and directions are discussed.
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Affiliation(s)
- Lesley A Shawler
- Department of Behavioral Psychology, Kennedy Krieger Institute, United States; Johns Hopkins University School of Medicine, United States.
| | - Joy C Clayborne
- Department of Behavioral Psychology, Kennedy Krieger Institute, United States
| | - Brian Nasca
- Department of Behavioral Psychology, Kennedy Krieger Institute, United States; Johns Hopkins University School of Medicine, United States
| | - Julia T O'Connor
- Department of Behavioral Psychology, Kennedy Krieger Institute, United States; Johns Hopkins University School of Medicine, United States
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14
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Rasheed MA, Mughis W, Elahi KN, Hasan BS. A Family-Centered Intervention to Monitor Children's Development in a Pediatric Outpatient Setting: Design and Feasibility Testing. FRONTIERS IN HEALTH SERVICES 2021; 1:739655. [PMID: 36926480 PMCID: PMC10012677 DOI: 10.3389/frhs.2021.739655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022]
Abstract
The patient experience team at a private tertiary care hospital used the Theory of Change to design a family-centered developmental monitoring intervention, building on an ongoing initiative. The design entailed (i) a monitoring form: Survey of Well-Being of Young Children (SWYC) being an easy parent-report measure; (ii) family support intervention: the Care for Child Development module to enhance parent-child interactions; (iii) timing: utilizing wait time to also enhance families' experience; (iv) the service providers: psychology trainees as volunteers; and (v) reinforcement: by the pediatrician in the regular consultation health visit capitalizing on the established rapport with families. All families with children under 5 years 5 months 31 days of age in selected acute, complex, and developmental care clinics were eligible. Feedback from stakeholders indicated that the monitoring process was useful and imparted important information for parents and pediatricians, while the trainees felt the experience to be significant for their own learning. The authors conclude that the designed intervention model for a family-centric approach was acceptable and feasible. Key recommendations have been presented for further scale-up.
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Affiliation(s)
- Muneera A Rasheed
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Waliyah Mughis
- Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Kinza Naseem Elahi
- Institute of Professional Psychology, Bahria University, Karachi, Pakistan
| | - Babar S Hasan
- Department of Paediatrics & Child Health, Aga Khan University, Karachi, Pakistan
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