Acceptability, feasibility and quality of telehealth for the delivery of health care to adolescents during the COVID-19 pandemic: a cross-sectional study of the experiences of patients and their families
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JMIR Pediatrician Parent. Nov 15, 2021; 4 (4): e32708. doi: 10.2196 / 32708.
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: The aim of this study was to assess the non-inferiority of telehealth versus in-person visits by comparing acceptability in terms of efficiency, effectiveness, equity, patient orientation and confidentiality.
METHODS: Cross-sectional online surveys were sent to caregivers and AYAs following video visits to a subspecialty clinic in Adolescent Medicine in May-July 2020. The proportions of AYA and caregivers who assessed the Telehealth as not inferior were compared using chi-square tests. Feasibility was assessed using items measuring technical difficulties. Deductive thematic analysis using the Institute of Medicine’s healthcare quality dimensions was used to code responses to open-ended questions.
RESULTS: Survey response rates were 20.5% (55/268) for AYA and 21.8% (123/563) for caregivers. The majority of respondents were white cisgender women. Most AYAs and caregivers rated telehealth as not inferior 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 in terms of confidentiality (11/51, 22% vs. 3/118, 2.5%, P <.001 a quarter of aya patients and caregivers reported technical difficulties. dominant themes in the qualitative data included benefits telehealth for efficiency equity health care delivery. however respondents concerns reduced safety effectiveness especially with eating disorders due to lack hands-on exams vital signs collection laboratory tests.>
CONCLUSIONS: Telehealth was highly acceptable among AYAs and caregivers. Future optimization should include improving confidentiality, improving technical difficulties, and standardizing home methods of obtaining patient data to ensure patient safety.