Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences
BackgroundData regarding the acceptability, feasibility, and quality of telehealth among adolescents and young adults (AYA) and their parents and caregivers (caregivers) are lacking. ObjectiveThe aim of this study was to assess the noninferiority of telehealth ver...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2021-11-01
|
| Series: | JMIR Pediatrics and Parenting |
| Online Access: | https://pediatrics.jmir.org/2021/4/e32708 |
| _version_ | 1797735563277631488 |
|---|---|
| author | 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 |
| author_facet | 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 |
| author_sort | Sarah M Wood |
| collection | DOAJ |
| description |
BackgroundData regarding the acceptability, feasibility, and quality of telehealth among adolescents and young adults (AYA) and their parents and caregivers (caregivers) are lacking.
ObjectiveThe 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.
MethodsCross-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.
ResultsSurvey 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.
ConclusionsTelehealth 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. |
| first_indexed | 2024-03-12T13:00:53Z |
| format | Article |
| id | doaj.art-d046b4d6e7e3472aa77044b4112dc614 |
| institution | Directory Open Access Journal |
| issn | 2561-6722 |
| language | English |
| last_indexed | 2024-03-12T13:00:53Z |
| publishDate | 2021-11-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Pediatrics and Parenting |
| spelling | doaj.art-d046b4d6e7e3472aa77044b4112dc6142023-08-28T19:46:38ZengJMIR PublicationsJMIR Pediatrics and Parenting2561-67222021-11-0144e3270810.2196/32708Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family ExperiencesSarah M Woodhttps://orcid.org/0000-0003-2478-4930Julia Pickelhttps://orcid.org/0000-0001-7484-7042Alexis W Phillipshttps://orcid.org/0000-0003-3973-9323Kari Baberhttps://orcid.org/0000-0001-6666-1694John Chuohttps://orcid.org/0000-0002-8981-9906Pegah Malekihttps://orcid.org/0000-0002-3634-2411Haley L Fausthttps://orcid.org/0000-0002-5406-9658Danielle Petsishttps://orcid.org/0000-0001-9533-4764Danielle E Applehttps://orcid.org/0000-0003-0278-311XNadia Dowshenhttps://orcid.org/0000-0002-8466-1628Lisa A Schwartzhttps://orcid.org/0000-0002-7034-9553 BackgroundData regarding the acceptability, feasibility, and quality of telehealth among adolescents and young adults (AYA) and their parents and caregivers (caregivers) are lacking. ObjectiveThe 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. MethodsCross-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. ResultsSurvey 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. ConclusionsTelehealth 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.https://pediatrics.jmir.org/2021/4/e32708 |
| spellingShingle | 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 Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences JMIR Pediatrics and Parenting |
| title | Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences |
| title_full | Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences |
| title_fullStr | Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences |
| title_full_unstemmed | Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences |
| title_short | Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences |
| title_sort | acceptability feasibility and quality of telehealth for adolescent health care delivery during the covid 19 pandemic cross sectional study of patient and family experiences |
| url | https://pediatrics.jmir.org/2021/4/e32708 |
| work_keys_str_mv | AT sarahmwood acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT juliapickel acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT alexiswphillips acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT karibaber acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT johnchuo acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT pegahmaleki acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT haleylfaust acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT daniellepetsis acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT danielleeapple acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT nadiadowshen acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences AT lisaaschwartz acceptabilityfeasibilityandqualityoftelehealthforadolescenthealthcaredeliveryduringthecovid19pandemiccrosssectionalstudyofpatientandfamilyexperiences |