Developing the Learning about Midwives and Birth Settings Video for Teaching About Birth Care Options

At my own pace, space, and place: a systematic review of qualitative studies of enablers and barriers to telehealth interventions for people with chronic pain

ABSTRACT

Telehealth is a promising approach to support self-management with the potential to overcome geographical barriers. Understanding patient perspectives will identify practical challenges to delivering self-management strategies by telehealth. The aim of this study was to synthesize the perceptions of people with chronic musculoskeletal pain for engaging in interventions delivered using telehealth. We searched MEDLINE, Embase, CINAHL, LILACS, and PsycINFO databases. We included qualitative studies that explored perceptions or experiences or attitudes of people with chronic musculoskeletal pain engaging with telehealth. We assessed the methodological quality using the Critical Appraisal Skills Programme checklist. Meta-synthesis was guided by a thematic synthesis approach. The level of confidence of review findings was assessed using the Confidence in the Evidence from Reviews of Qualitative Studies (GRADE-CERQual). Twenty-one studies were included (n = 429). Telehealth comprised web-based, videoconference-based, telephone-based, video-based, and smartphone app-based programs delivered solely or combined. Chronic musculoskeletal conditions included people with knee or hip osteoarthritis, chronic low back pain, persistent pain (chronic joint pain or nonspecific chronic musculoskeletal pain), rheumatoid arthritis, and functional fatigue syndrome. The enablers for engaging in telehealth interventions were as follows: (1) "at my own pace, space, and place" and (2) empowered patient. Barriers to engaging in telehealth interventions were as follows: (1) impersonal, (2) technological challenges, (3) irrelevant content, and (4) limited digital (health) literacy. Telehealth interventions with well-designed interactive platforms, flexibility to fit patients' routine, and the broad availability of material may favor better engagement. Encouragement of self-efficacy is linked to successful telehealth-delivered self-management programs.

The Birth Education Starts Today Video on Birth Care Options: Evaluation With University Students

Despite evidence indicating that midwife-attended birth is safe and satisfactory, few U.S. families have credentialed midwives as their birth care providers. In the context of person-centered health care and improving maternity care, we evaluated how an author-constructed video featuring evidence and personal narratives on midwifery care affected attitudes and care preferences/intentions for a hypothetical future birth among university students who had not become parents. Students (114 women, 30 men) completed care attitude and preference items before and after viewing the video. Significant (p < .001) changes indicated significantly improved attitudes toward midwives and out-of-hospital birth and related preferences. We discuss the educational framework of the video and plans to determine whether short-term effects translate into care-seeking behavior across diverse populations.