Emily E Johnson1, Claire MacGeorge2, Kathryn L King3, Annie L Andrews4, Ronald J Teufel5, Ryan Kruis6, Kathryn C Hale7, Dee W Ford8, Katherine R Sterba9. 1. Associate Professor, Medical University of South Carolina (MUSC), College of Nursing, 99 Jonathan Lucas Street, Charleston, SC 29425, USA. Electronic address: johnsoem@musc.edu. 2. MUSC-Department of Pediatrics, 135 Rutledge Avenue, MSC 561, Charleston, SC 29425, USA. Electronic address: macgeorg@musc.edu. 3. Associate Executive Medical Director-Center of Telehealth-MUSC, Charleston, SC 29425, USA. Electronic address: kingkl@musc.edu. 4. MUSC-Department of Pediatrics, 135 Rutledge Ave, MSC 561, Charleston, SC 29425, USA. Electronic address: andrewsan@musc.edu. 5. MUSC-Department of Pediatrics, 135 Rutledge Ave, MSC 561, Charleston, SC 29425, USA. Electronic address: teufelr@musc.edu. 6. MUSC, Charleston, SC 29425, USA. Electronic address: kruis@musc.edu. 7. MUSC-Center for Telehealth, School-Based Health Program Coordinator, Charleston, SC 29425, USA. Electronic address: halek@musc.edu. 8. Professor of Medicine, Progream Director, Center for Telehealth, MUSC, Charleston, SC 29425, USA. Electronic address: fordd@musc.edu. 9. Associate Professor of Public Health Sciences, Medical University of South Carolina, Department of Public Health Sciences, 68 President Street, MSC 955, Charleston, SC 29425, USA. Electronic address: sterba@musc.edu.
Abstract
OBJECTIVE: Asthma is one of the most common chronic conditions of childhood, conferring an immense burden on children and their caregivers. School-based telehealth approaches for asthma care provide the opportunity to deliver convenient, cost-effective care to more children in the school setting. Our study objective was to characterize school-based telehealth asthma program delivery experiences and examine barriers and facilitators to telehealth program implementation. METHODS: Interviews were conducted with telehealth program staff and school stakeholders in nine schools engaged in a school-based telehealth asthma program. A structured interview guide was designed using the Exploration, Adoption/Preparation, Implementation, Sustainment (EPIS) framework. A template analysis qualitative approach was used to identify themes related to implementation processes. RESULTS: Interviews identified key telehealth implementation strategies including building relationships, marketing and provision of technical assistance, education and support to aid program delivery. Key facilitators to successful program implementation included strong partnerships between the telehealth and school teams, a shared commitment to enhancing access to asthma care for children, and strong nurse leadership. Primary barriers to implementation included lack of family/caregiver involvement and competing demands for nurses. CONCLUSIONS: This study identified barriers and facilitators to implementing a school-based telehealth asthma program that can be used to guide education, training and support strategies to enhance program delivery. Recommended implementation strategies include building strong program-school partnerships, creating a shared vision to improve access to care, and building engagement in families and communities while supporting nurse leaders and family involvement with training and resources. These results can help guide future telehealth interventions.
OBJECTIVE:Asthma is one of the most common chronic conditions of childhood, conferring an immense burden on children and their caregivers. School-based telehealth approaches for asthma care provide the opportunity to deliver convenient, cost-effective care to more children in the school setting. Our study objective was to characterize school-based telehealth asthma program delivery experiences and examine barriers and facilitators to telehealth program implementation. METHODS: Interviews were conducted with telehealth program staff and school stakeholders in nine schools engaged in a school-based telehealth asthma program. A structured interview guide was designed using the Exploration, Adoption/Preparation, Implementation, Sustainment (EPIS) framework. A template analysis qualitative approach was used to identify themes related to implementation processes. RESULTS: Interviews identified key telehealth implementation strategies including building relationships, marketing and provision of technical assistance, education and support to aid program delivery. Key facilitators to successful program implementation included strong partnerships between the telehealth and school teams, a shared commitment to enhancing access to asthma care for children, and strong nurse leadership. Primary barriers to implementation included lack of family/caregiver involvement and competing demands for nurses. CONCLUSIONS: This study identified barriers and facilitators to implementing a school-based telehealth asthma program that can be used to guide education, training and support strategies to enhance program delivery. Recommended implementation strategies include building strong program-school partnerships, creating a shared vision to improve access to care, and building engagement in families and communities while supporting nurse leaders and family involvement with training and resources. These results can help guide future telehealth interventions.
Authors: Jennifer R Mammen; Colleen M McGovern; Judith D Schoonmaker; Ashley Philibert; Emma C Schlegel; Kimberly Arcoleo Journal: J Asthma Date: 2021-12-28