Claire A MacGeorge1, Kathryn King1, Annie L Andrews1, Katherine Sterba1,2, Emily Johnson1,3, Daniel L Brinton1,4, Ronald J Teufel1, Ryan Kruis1,5, Dee Ford1,6. 1. Pediatrics, Medical University of South Carolina, Charleston, SC, USA. 2. Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA. 3. College of Nursing, Medical University of South Carolina, Charleston, SC, USA. 4. College of Health Professions, Medical University of South Carolina, Charleston, SC, USA. 5. Center for Telehealth, Medical University of South Carolina, Charleston, SC, USA. 6. Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston, SC, USA.
Abstract
OBJECTIVE: School-based telehealth (SBTH) offers an opportunity to overcome traditional barriers to providing comprehensive asthma care for children. Guided by an implementation science framework considering factors internal and external to the school setting, we characterized barriers and facilitators to asthma care within an existing SBTH program available in over 50 under-resourced South Carolina schools. METHODS: This cross-sectional study assessed barriers and facilitators to SBTH asthma care delivery using web-based surveys of school nurses, specifically addressing school implementation of telehealth methods. Surveys evaluated practices and nurse and school-specific factors related to telehealth implementation including perceived barriers, organizational readiness and self-efficacy. Utilizers were schools who completed 1-10 average visits per month while non-utilizers completed less than 1 average visit per month. Descriptive statistics were performed to characterize perceptions in utilizers versus non-utilizers. RESULTS: Of 53 surveys distributed, 36 were completed (68% response rate). Commonly cited barriers included inadequate time due to competing tasks in both utilizers (65%) and non-utilizers (74%) as well as lack of caregiver involvement in care planning (94% of utilizers and 84% of non-utilizers). Of those utilizing specific, relevant telehealth services, schools scored high in perceptions of organizational readiness (n = 24, mean: 24.5/30), self-efficacy (n = 26, mean: 3.6/5) and comfort with identifying students eligible for SBTH (n = 26, mean: 3.5/5). CONCLUSIONS: We identified inadequate nurse time and challenges engaging caregivers as key barriers to implementation of a school-based telehealth asthma program providing care to an under-resourced population. Addressing these barriers when expanding telehealth services may promote utilization of telehealth.
OBJECTIVE: School-based telehealth (SBTH) offers an opportunity to overcome traditional barriers to providing comprehensive asthma care for children. Guided by an implementation science framework considering factors internal and external to the school setting, we characterized barriers and facilitators to asthma care within an existing SBTH program available in over 50 under-resourced South Carolina schools. METHODS: This cross-sectional study assessed barriers and facilitators to SBTH asthma care delivery using web-based surveys of school nurses, specifically addressing school implementation of telehealth methods. Surveys evaluated practices and nurse and school-specific factors related to telehealth implementation including perceived barriers, organizational readiness and self-efficacy. Utilizers were schools who completed 1-10 average visits per month while non-utilizers completed less than 1 average visit per month. Descriptive statistics were performed to characterize perceptions in utilizers versus non-utilizers. RESULTS: Of 53 surveys distributed, 36 were completed (68% response rate). Commonly cited barriers included inadequate time due to competing tasks in both utilizers (65%) and non-utilizers (74%) as well as lack of caregiver involvement in care planning (94% of utilizers and 84% of non-utilizers). Of those utilizing specific, relevant telehealth services, schools scored high in perceptions of organizational readiness (n = 24, mean: 24.5/30), self-efficacy (n = 26, mean: 3.6/5) and comfort with identifying students eligible for SBTH (n = 26, mean: 3.5/5). CONCLUSIONS: We identified inadequate nurse time and challenges engaging caregivers as key barriers to implementation of a school-based telehealth asthma program providing care to an under-resourced population. Addressing these barriers when expanding telehealth services may promote utilization of telehealth.
Entities:
Keywords:
Pediatrics; implementation; organizational readiness; school
Authors: Emily E Johnson; Claire MacGeorge; Annie Andrews; Kathryn L King; Ronald J Teufel; Daniel L Brinton; Ryan Kruis; Kathryn C Hale; Dee Ford; Kathryn R Sterba Journal: Telemed J E Health Date: 2021-06-21 Impact factor: 5.033