Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences.
COVID-19
acceptability
adolescent
cross-sectional
efficiency
equity
experience
feasibility
patient experience
survey
teenager
telehealth
telemedicine
young adult
Journal
JMIR pediatrics and parenting
ISSN: 2561-6722
Titre abrégé: JMIR Pediatr Parent
Pays: Canada
ID NLM: 101727244
Informations de publication
Date de publication:
15 Nov 2021
15 Nov 2021
Historique:
received:
23
08
2021
accepted:
06
10
2021
revised:
27
09
2021
entrez:
15
11
2021
pubmed:
16
11
2021
medline:
16
11
2021
Statut:
epublish
Résumé
Data regarding the acceptability, feasibility, and quality of telehealth among adolescents and young adults (AYA) and their parents and caregivers (caregivers) are lacking. The aim of this study was to assess the noninferiority of telehealth versus in-person visits by comparing acceptability with respect to efficiency, effectiveness, equity, patient-centeredness, and confidentiality. Cross-sectional web-based surveys were sent to caregivers and AYA following video visits within an Adolescent Medicine subspecialty clinic in May-July 2020. Proportions of AYA and caregivers who rated telehealth as noninferior were compared using chi-squared tests. Feasibility was assessed via items measuring technical difficulties. Deductive thematic analysis using the Institute of Medicine dimensions of health care quality was used to code open-ended question responses. Survey response rates were 20.5% (55/268) for AYA and 21.8% (123/563) for caregivers. The majority of the respondents were White cisgender females. Most AYA and caregivers rated telehealth as noninferior to in-person visits with respect to confidentiality, communication, medication management, and mental health care. A higher proportion of AYA compared to caregivers found telehealth inferior with respect to confidentiality (11/51, 22% vs 3/118, 2.5%, P<.001). One-quarter (14/55) of the AYA patients and 31.7% (39/123) of the caregivers reported technical difficulties. The dominant themes in the qualitative data included advantages of telehealth for efficiency and equity of health care delivery. However, respondents' concerns included reduced safety and effectiveness of care, particularly for patients with eating disorders, owing to lack of hands-on examinations, collection of vital signs, and laboratory testing. Telehealth was highly acceptable among AYA and caregivers. Future optimization should include improving privacy, ameliorating technical difficulties, and standardizing at-home methods of obtaining patient data to assure patient safety.
Sections du résumé
BACKGROUND
BACKGROUND
Data regarding the acceptability, feasibility, and quality of telehealth among adolescents and young adults (AYA) and their parents and caregivers (caregivers) are lacking.
OBJECTIVE
OBJECTIVE
The aim of this study was to assess the noninferiority of telehealth versus in-person visits by comparing acceptability with respect to efficiency, effectiveness, equity, patient-centeredness, and confidentiality.
METHODS
METHODS
Cross-sectional web-based surveys were sent to caregivers and AYA following video visits within an Adolescent Medicine subspecialty clinic in May-July 2020. Proportions of AYA and caregivers who rated telehealth as noninferior were compared using chi-squared tests. Feasibility was assessed via items measuring technical difficulties. Deductive thematic analysis using the Institute of Medicine dimensions of health care quality was used to code open-ended question responses.
RESULTS
RESULTS
Survey response rates were 20.5% (55/268) for AYA and 21.8% (123/563) for caregivers. The majority of the respondents were White cisgender females. Most AYA and caregivers rated telehealth as noninferior to in-person visits with respect to confidentiality, communication, medication management, and mental health care. A higher proportion of AYA compared to caregivers found telehealth inferior with respect to confidentiality (11/51, 22% vs 3/118, 2.5%, P<.001). One-quarter (14/55) of the AYA patients and 31.7% (39/123) of the caregivers reported technical difficulties. The dominant themes in the qualitative data included advantages of telehealth for efficiency and equity of health care delivery. However, respondents' concerns included reduced safety and effectiveness of care, particularly for patients with eating disorders, owing to lack of hands-on examinations, collection of vital signs, and laboratory testing.
CONCLUSIONS
CONCLUSIONS
Telehealth was highly acceptable among AYA and caregivers. Future optimization should include improving privacy, ameliorating technical difficulties, and standardizing at-home methods of obtaining patient data to assure patient safety.
Identifiants
pubmed: 34779782
pii: v4i4e32708
doi: 10.2196/32708
pmc: PMC8594732
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e32708Subventions
Organisme : NIMH NIH HHS
ID : K23 MH119976
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI045008
Pays : United States
Informations de copyright
©Sarah M Wood, Julia Pickel, Alexis W Phillips, Kari Baber, John Chuo, Pegah Maleki, Haley L Faust, Danielle Petsis, Danielle E Apple, Nadia Dowshen, Lisa A Schwartz. Originally published in JMIR Pediatrics and Parenting (https://pediatrics.jmir.org), 15.11.2021.
Références
JMIR Mhealth Uhealth. 2021 Jul 8;9(7):e29619
pubmed: 34255706
JMIR Pediatr Parent. 2020 Oct 12;3(2):e23057
pubmed: 33001834
J Gen Intern Med. 2021 Aug;36(8):2274-2282
pubmed: 34027612
Matern Child Health J. 2019 Sep;23(9):1196-1205
pubmed: 31228142
J Gen Intern Med. 2021 Jan;36(1):256-258
pubmed: 33105000
Pediatrics. 2020 Nov;146(5):
pubmed: 32817398
J Biomed Opt. 2020 Oct;25(10):
pubmed: 33089674
Neurology. 2020 Sep 1;95(9):e1257-e1266
pubmed: 32518152
Curr Opin Obstet Gynecol. 2018 Dec;30(6):458-464
pubmed: 30299318
Lancet Psychiatry. 2021 Aug;8(8):663-672
pubmed: 34090582
Pediatrics. 2018 Mar;141(3):
pubmed: 29487164
J Am Coll Surg. 2020 Dec;231(6):695-702
pubmed: 32891797
MMWR Morb Mortal Wkly Rep. 2021 Jun 18;70(24):888-894
pubmed: 34138833
Telemed J E Health. 2021 Feb;27(2):178-183
pubmed: 32589518
JAMA Netw Open. 2020 Jun 1;3(6):e205873
pubmed: 32585018
JMIR Rehabil Assist Technol. 2020 Aug 4;7(2):e16004
pubmed: 32749229
J Am Med Inform Assoc. 2020 Jul 1;27(7):1116-1120
pubmed: 32302395
J Adolesc Health. 2020 Aug;67(2):164-171
pubmed: 32410810
Pediatrics. 2021 Sep;148(3):
pubmed: 34140393
Ann Intern Med. 2015 Nov 17;163(10):787-9
pubmed: 26344925
J Adolesc Health. 2020 Aug;67(2):157-158
pubmed: 32517972
JMIR Pediatr Parent. 2020 Jun 25;3(1):e20049
pubmed: 32540841
Int J Telerehabil. 2016 Jul 01;8(1):3-10
pubmed: 27563386
Telemed J E Health. 2017 Oct;23(10):842-846
pubmed: 28426367
J Adolesc Health. 2020 Oct;67(4):469-471
pubmed: 32768330
J Adolesc Health. 2020 Aug;67(2):172-178
pubmed: 32611509
J Med Internet Res. 2020 Sep 25;22(9):e19992
pubmed: 32877352