'It really is quite a different ballgame'. A qualitative study into the work experiences of remote support professionals.

BACKGROUND: Professional support for people with intellectual disabilities is increasingly provided remotely. This study explores what support staff of the Dutch remote support service DigiContact experience as distinctive aspects of their job as a remote support professional.
METHOD: Semi-structured interviews were held with 10 DigiContact support workers. The transcripts were analysed through a qualitative content analysis process.
RESULTS: Six themes were identified that reflect distinct aspects of the participants' work within the DigiContact remote support context: being encouraged to adopt a solution-oriented coaching support style; being limited in one's support options; facing considerable diversity; providing support as one team; dealing with unpredictability; and navigating the dynamic within work shifts.
CONCLUSIONS: The way support is organised and delivered can have substantial implications for support professionals. Working at a service like DigiContact seems to call for specific skills, knowledge, affinities and experience, and for appropriate support and facilitation from organisations.

INTRODUCTION

Professional support for people with intellectual disabilities is increasingly provided remotely through the use of online devices like smartphones, computers and tablets (Friedman & Rizzolo, 2017; Taber‐Doughty et al., 2010; Tassé et al., 2020). Research has shown that a remote provision of support can have several benefits, such as an enhanced efficiency in services and an increased accessibility of support (e.g., Brewer et al., 2010; Cullen et al., 2012; de Wit et al., 2015; Niemeijer et al., 2010; Zaagsma, Volkers, Koning, et al., 2020). The effects of the COVID‐19 pandemic have increased the uptake of remote support initiatives, as organisations search for ways to improve the continuity of their services during phases of lockdown and active social distancing measures (Doody & Keenan, 2021; Wos et al., 2021; Zaagsma, Volkers, Swart, et al., 2020).

A remote provision of support departs from the way in which services for people with intellectual disabilities are usually delivered, which is through onsite support staff (Stancliffe & Lakin, 2007). A remote support delivery may impact the experiences of both those who are supported (people with intellectual disabilities) and those who provide support (professionals). Studies on the experiences of people with intellectual disabilities linked a remote provision of support to an increased sense of independence and control over one's support (Brewer et al., 2010; Tassé et al., 2020; Zaagsma et al., 2021), feelings of security and safety (de Wit et al., 2015; Tassé et al., 2020), and concerns related to privacy issues (Tassé et al., 2020). Similar findings were reported by Frielink et al. (2021), who explored the expectations and perceptions of people with intellectual disabilities, relatives and professionals regarding the use of eHealth, a broader concept that included remote support.

As far as we know, the experiences of remote support workers in intellectual disability services have only been examined by de Wit et al. (2015), who explored the experiences of remote support staff as part of their feasibility study on a web‐based support programme for people with mild intellectual disabilities or chronic psychiatric disorders. In addition to greater flexibility in their scheduling, the staff felt that their support became more directed towards encouraging support users to draw on their personal strengths and skills when executing daily tasks. Broadening our view by looking at other care sectors, studies from mental health care and social care for the elderly show that remote care workers experience a need to adapt their way of communicating with care users as the possibilities to use nonverbal communication are limited (e.g., Barbosa & Silva, 2017; Mallen et al., 2005; Rees & Stone, 2005). Although video calls allow for the transfer of nonverbal communication signs, the process of perceiving and interpreting nonverbal signals may still be relatively complex (Barbosa & Silva, 2017; Rees & Stone, 2005).

As remote support is expected to become more common in the field of intellectual disability (Friedman & Rizzolo, 2017; Tassé et al., 2020), it is important to understand the specificities and complexities that come with the task of providing professional support remotely. The purpose of this paper is to contribute to this understanding by exploring the experiences of support staff of the Dutch remote support service DigiContact. This service offers 24/7 available remote support for daily functioning to people with intellectual disabilities who live relatively independently in their own homes. The support is provided during live contacts in the form of both (online) video calls and (offline) regular phone calls. We specifically aim to answer the following question: What do DigiContact support workers experience as distinctive aspects of their job as a remote support professional?

METHODS

Design

A qualitative research approach was adopted, in which one‐off semi‐structured interviews with support workers of the remote support service DigiContact were used to collect data. These interviews were part of a broader study in which the support practice of DigiContact support staff was explored (a partner paper on what the support staff does to support people with intellectual disabilities is currently under review). Data from the interviews were inductively analysed with respect to the research question.

Context: DigiContact

DigiContact is a remote support service of the Dutch service provider Philadelphia Care Foundation. The service offers 24/7 available and remote professional support for daily functioning to people with intellectual disabilities who live in their own homes, either alone or with a partner/family. The support is provided by specially trained support workers during live contacts in the form of video calls (online) and audio‐only calls (online and offline). During video calls, it is usually not possible to look straight at each other and make eye contact at the same time. This is due to the position of the camera, which is above the screen on which the video image is displayed. DigiContact uses a system in which a specially coated (half‐mirrored) glass panel is positioned at a certain angle in front of the support workers' screen that places the camera optically in the middle of the video image. This enables support workers to look at the person on the screen and creates the impression of direct eye contact for both support workers and people with intellectual disabilities. Table 1 provides an overview of DigiContact support characteristics.

TABLE 1

Characteristics of DigiContact support

Characteristics	Description
24/7	Support is available 24 h a day, 7 days a week.
Support is provided from a distance	Support workers are working from one central location (with call‐centre facilities).
Devices are used to realise contact	Support users use either their own device (e.g., tablet, pc, smartphone, landline phone) to contact the service or a tablet they receive on loan from the service provider organisation. Technological support is available in the form of technicians who assist either from a distance or at home. Contacts can be with or without video component. For video, access to the Internet is necessary. Without Internet connection, contact is possible through regular (landline) phone.
Planned and unplanned support	Contacts can be planned and unplanned. Planned contacts are with appointment, usually according to an agreed on time interval. Unplanned contacts are without appointment, whenever and as often as a support user needs support.
No fixed contacts between support workers and support users	Support users cannot choose which support worker they speak to: they talk to the support worker who picks up their call. Support workers provide support to those support users who call in during their shifts.

DigiContact was originally developed and implemented as part of a broader package of services for people with intellectual disabilities who live in their own homes (generally alone, with a partner, or with family) and who have been found eligible for access to specialist long‐term intellectual disability support services (Vijfhuizen & Volkers, 2016). Its remote support is usually combined with onsite support from a support worker who visits support users at home or at a community centre. Over the recent years, its support user group has increased substantially, and now also includes people in supported accommodation settings and people with dementia in early stages or mental health problems. Around the time we collected the data for this study (date January 2020), around 1500 support users were connected to the service, of which about 80% were independently living people with intellectual disabilities.

DigiContact support workers work in rotating shifts to enable the 24/7 availability of the service. They are especially recruited and trained to provide remote support (e.g., on their ability to perform sedentary work and their affinity with technology). Newly hired support workers go through an extended period of on‐the‐job training, organised through successive periods of observing colleagues, supervised working and a buddy system in which they are linked to a more senior colleague with whom they have regular meetings to discuss their work.

Sampling and recruitment

A combination of convenience and purposive sampling procedures (Patton, 2005) was employed. At the time of planning and organising the interviews (December 2019), the DigiContact support staff team consisted of 25 remote support workers. Three support workers were excluded a priori, because they had joined the team less than 6 months before (exclusion criterion) and therefore had not had much opportunity to build up experience with working at DigiContact. An informational e‐mail with an appeal to participate in an interview was sent to the remaining 22 support workers. Seven support workers responded and confirmed their willingness to participate (convenience sample). Based on three characteristics of this group of seven (sex, length of time working at DigiContact, and having previous experience with providing onsite support), five additional support workers were selected (purposive sample) with the intention of obtaining a final sample that was representative of the original group of 22 support workers. These five support workers were contacted again personally. One of them did not want to participate, because (s)he felt not experienced enough to reflect on her/his work (this person had been working at the DigiContact service for 7 months). Another support worker was not interviewed as we failed to plan an interview due to conflicting agendas. This left us with a final sample of 10 participants (see Table 2).

TABLE 2

Characteristics of the participants and the DigiContact support staff team

	Participants (n = 10)	Team (n = 22) a
Woman, %	80	73
Years of experience with online support, M (SD)	3,1 (1,9)	2,7 (1,8)
Experience with onsite support, %	90	86

Excluding support workers (n = 3) who had been working at DigiContact for less than 6 months when the recruitment for interviews took place.

Data collection

A guide for semi‐structured interviews was developed based on insights into the daily practice of DigiContact remote support staff, acquired through a content analysis of seven DigiContact documents (manual, job description, two informational documents for new staff members, two brochures for support users and their families, and a text on the service organisation's website) and 40 transcripts of interviews with support users and case workers from previous studies on DigiContact (Zaagsma et al., 2019, 2021; Zaagsma, Volkers, Koning, et al., 2020). The interview guide included four main topics: values and goals in support, activities and strategies, working in a team, and conditions for providing good support. For each main topic several open ended questions were developed. Although the participants provided support to a broader range of service users, the focus of the interviews was on support for independently living people with intellectual disabilities.

All interviews were conducted face‐to‐face (between December 2019 and March 2020) by the first and second author together, and they lasted between 47 and 86 min. The interviews were carried out in Dutch, as this was the native language of all participants and the researchers. Each interview was audio‐recorded with participant approval and transcribed verbatim. Member validation was used as a validity check method (Green & Thorogood, 2014): each participant received a typed summary of their interview to check for accuracy. Although all participants felt that the summary represented their experiences well, one participant provided additional input to nuance her/his views regarding the conditions for providing good support. Quotes that are included in the results section, were translated by a professional with an English language proficiency of a native speaker.

Data analysis

The transcripts were analysed through a qualitative content analysis process based on a general inductive approach as described by Thomas (2006). All authors were involved in data analysis. First, each transcript was read thoroughly and coded by the first author and at least one other author. Codes applied to the same transcript by different authors were compared and discussed if necessary. Next, the first author grouped the codes into categories, and the categories into themes. The categories and themes were further refined through discussion with the second author (Table 3).

TABLE 3

Overview of themes, categories, and the underlying support characteristics

DigiContact support characteristics	Themes	Categories
Support is delivered remotely	Being encouraged to adopt a solution‐oriented coaching support style	Being stimulated to adopt a coaching support style Being enabled to focus on the issue(s) for which contact is sought
	Being limited in one's support options	Getting a full picture of the support user's situation is difficult
		Missing nonverbal signals in audio‐only contacts
		Being limited in what one can do to help
No fixed contacts between support workers and support users	Facing considerable diversity	Needing to be a ‘jack of all trades’
		Adopting a personalised approach is complicated
	Providing support as one team	Presenting oneself as a representative of the service
		Aiming for a high level of uniformity in support
		Sharing tasks and responsibilities with colleagues
Support contacts can be planned and unplanned	Dealing with unpredictability	Not knowing what to expect
		Not being able to prepare
	Navigating the dynamic within work shifts	Making quick mental switches between support contacts
		Multi‐tasking during support contacts

Ethical procedure

The Medical Ethics Review Committee of VU University Medical Center (FWA00017598) confirmed that official approval was not required as the Dutch Medical Research Involving Human Subjects Act (WMO) did not apply to the study of which the interviews were part. The researchers followed the Disability Studies in the Netherlands Code of Practice in Research (Disability Studies in the Netherlands, 2017). Written informed consent was obtained from all participants. Audio‐recordings were made after the participants gave their approval and the audio files were destroyed after analysis had been completed. All data were anonymized and subsequently handled and stored with care and respect for privacy.

RESULTS

Support is delivered remotely

The first support characteristic that played a prominent role in the experiences of the participants was the fact that support is provided from a distance (through video calls or regular phone calls). This support characteristic was associated with two themes that show that providing support can be both facilitated and hindered by the distance.

First, providing support from a distance was felt to encourage a solution‐oriented coaching support style. This style is characterised by a focus on (a) the questions and/or issues that are bothering support users at the time of the contact, and (b) the intention to stimulate support users to take on an active role—as much as possible—in thinking about possible answers and solutions and deploy their own skills, knowledge and talents to solve issues (and through this empower them). More information on this support style is provided in a partner paper on what DigiContact support workers do to support people with intellectual disabilities and how they do this (currently under review). The participants talked about how not being present in the same room as a support user facilitates the adoption of a solution‐oriented coaching support style. To begin with, they felt that the distance prevented them from taking over tasks and stimulated the adoption of a coaching style in their contacts:

We need to empower the clients, to me that is very important. And I think we are pretty good at that, because we are at a physical distance. I feel this makes it easier to stimulate their independence, as we are not able to take over much. (Participant 5)

In addition, the participants also felt that the distance enabled a strong focus on the issue for which contact is sought. Not only did they experience relatively little distraction from things or people in the support user's environment, but they also felt that not being in the same room (and not knowing each other well personally) made it easier to come to the point quickly:

We are not visiting someone, so the situation is not one of ‘Hi, how are you and what happened since last we saw each other and how about a cup of coffee?’. We generally skip all that. So this digital contact creates a different venue. (Participant 3)

Second, providing support from a distance was felt to limit their support options. The participants talked about how communicating through a video call or regular phone call (audio‐only) made it difficult to get a full picture of the support user's situation. It was, for example, often impossible to gather information from the support user's environment and the people in it. This may especially be the case when the focus in the conversations is primarily on the issue(s) for which contact is sought. Some participants stressed that having onsite work experience with (independently living) people with intellectual disabilities is important, as this can lead to more awareness of (and sensitivity towards) how complex and multi‐faceted the situations of support users may be:

I consider it important that we have some experience in onsite support, because it means we have visited people at home and that we have seen how things go within the family. Without that experience it would be more difficult to assess situations. […] It would be ideal to combine this job with working onsite one day a week. To keep in touch with the problems that clients face. (Participant 9)

Regarding audio‐only contacts, the participants acknowledged that they risked missing nonverbal signals that can be important for understanding a support user well:

It gets to be very challenging when you have to miss out on visual information. […]You've got no idea how the other person is looking or what he is thinking. It helps to be able to see someone's face. I see non‐verbal language as an important part of the conversation. Without that information you may well miss the underlying layers of the conversation. (Participant 8)

Finally, the participants also felt that not being present in the same room limited their options as to what they can do to help support users, as they were largely restricted to supporting by talking only:

Well, we have limited options of course, because when you are present, you can help the client by pushing a bit or by starting with practical matters. However, we can help by talking only or by showing something with our hands. This challenges me to look for how I can help someone best. (Participant 5)

No fixed contacts between support workers and support users

The second support characteristic that played an important role in the participants' experiences, was the fact that there are no fixed contacts between support workers and support users. This means that instead of providing support to a certain subgroup of support users, DigiContact support workers offer their assistance to all support users who call in during their work shifts. This can be any one of the total group of about 1500 connected support users. For a support worker, it is not uncommon to have between 20 and 30 support contacts with different support users during one (daytime) work shift. This characteristic was associated with two themes.

First, the participants felt that their work was characterised by an experience of being faced with considerable diversity amongst support users (e.g., with respect to their support needs, communication styles, and/or socio‐cultural backgrounds), and the issues for which the service was contacted. This diversity was generally felt to make their work interesting and dynamic. However, this diversity also required them to be a ‘jack of all trades’: ‘I like the fact that the questions and problems of our clients are so varied. […] We have more clients, with more issues and questions. We need to know a lot of many different things, which is quite demanding’ (Participant 2). In addition, the diversity was felt to complicate the task of adopting a personalised approach. In this respect, participants stressed the importance of having access to up‐to‐date information on each individual user, as well as on previous professional support contacts:

I do think that one of the basic aspects of this job is being able to adapt to the person you are talking with. You can do this by observing. We get to speak to so many clients that we do not know all of them well. The clients who call in often we know quite well, but others we do not know so well. That makes the information in the client file on how to relate to this person very important, indeed. (Participant 10)

They also talked about the essential importance of being quite receptive and sensitive to the needs and preferences of individual support users, and able to flexibly adapt one's approach.

Second, being a support worker at DigiContact was characterised as a team effort, and it was felt to be important to provide support as one team. The participants talked about how they presented themselves as a representative of the service:

Sometimes clients want to know something about you personally, which is generally fine. However, you are first and foremost a representative of DigiContact and not [own first name]. That is necessary to prevent clients from forming an attachment with you as a person which will lead to the client wanting to speak with you every time they call in. That is not the purpose of DigiContact. And it should not be anyone's purpose at Digi, I think. (Participant 8)

Besides stressing their intention to adopt a personalised approach to support (accommodating to the needs, wishes and preferences of individual support users), the participants talked about how important it is that a support user is supported in more or less the same way by different support workers:

We are working with so many colleagues. When all of us deal with issues [of a certain client] in more or less the same way and stick to that approach, a client gets to know what we as a service can offer and is likely to expect that. It will reduce uneven expectations. (Participant 3)

In order to realise this, the participants committed themselves to an intensive collaboration with colleagues in order to align their approach and strategies. Finally, participants felt that working as one team also meant that they shared tasks and responsibilities. They talked about the comforts of having a colleague near when they need advice or support, and being able to ‘check out’ when their shift ends as there is always a colleague who takes over. Together, such aspects of their job were experienced to lower the pressure of supporting so many support users:

You know that this is a non‐stop business, there will always be a colleague ready to take over once your shift ends. That makes it easier to let go of the responsibility, and not get too emotionally involved. You are close to the client and you have a warm contact, but you need to close the door behind you at the end of your shift. (Participant 3)

Support contacts can be planned and unplanned

The third support characteristic that played an important role in the participants' experiences, was the fact that support users can contact the service with or without an appointment. The opportunity to call in without an appointment (unplanned) is used fairly frequently: about a quarter of all support contacts comes about without an appointment. This support characteristic was associated with two themes.

First, the unplanned support contacts led to a feeling of having to deal with unpredictability. The participants talked about how not knowing in advance who will call in and about what, brought uncertainty regarding what to expect. While this uncertainty was for some participants stressful, for others this just made their job more exciting. As one participant put it:

So we always need to be prepared for the worst. Because we are frequently confronted with some tough situations. You may just lift the phone and find someone at the other hand who claims to be at the end of their tether and wants to end her or his life. At such a moment you need all your wits. (Participant 1)

Having unplanned contacts also made it impossible to prepare oneself for a contact:

It happens that more than half of your contacts with clients are unplanned. And once clients call in, you can't just tell them: ‘Wait a minute, be quiet, I need to look you up’. You do need that information, but you've got to look it up as you go. So sometimes you can prepare and sometimes you can't. (Participant 4)

Second, unplanned contacts were associated with an experience of navigating the dynamic within a work shift. This was characterised by alternating periods of high‐intensity activity (many contacts coming in closely together) and relative calm. Regularly, the pace of incoming calls was so high, that participants felt they had little time, or no time at all, to rewind or reset their mind in between contacts. They expressed that they had to make quick mental switches in order to keep going and give each support user genuine attention and commitment:

It really is quite a different ballgame. It is important to be able to switch quickly between contacts and clients. During onsite work you move from one client to the next and you have some time in between, while cycling or walking or driving. During online work you don't have that opportunity. Also, it might be the case that one call is really tough, because the client's problems are so big or so distressing, but the next call deserves your full attention as well, regardless of the seriousness of that client's issues. (Participant 2).

In addition, the participants felt that multi‐tasking was an important part of their work, as they had to find and read information within several electronic client file systems for different support user groups during their contacts:

So when the conversation starts, we search for the right [electronic client file] system. We look up what we have on how to relate to this specific client and we scan the most recent reports. […] So our work really involves multitasking. (Participant 1)

DISCUSSION

This study provides insight into the work experiences of support staff from the remote support service DigiContact. Through semi‐structured interviews with 10 members of the DigiContact support staff team, we identified and described aspects that were considered to be distinctive to their work as a remote support worker. The findings show that how support is organised and delivered can have substantial implications for support workers and their practice of supporting people with intellectual disabilities.

To begin with, a remote delivery of support was found to bring both opportunities and limitations to the process of supporting people with intellectual disabilities. On the one hand, not being present at the same spot as the support user facilitated a focus on those issues for which support was sought, as well as the adoption of a coaching role towards support users. The coaching role of support workers was recognised by DigiContact support users (Zaagsma et al., 2021), and corresponds to the findings of de Wit et al. (2015), who found that the support provided by staff of a web‐based support programme encouraged people to draw on their own personal strengths and skills when executing daily tasks. On the other hand, the distance between support workers and support users was also seen as limiting in terms of the opportunity to gather information and one's range of action. Again, this was acknowledged by support users, as they felt that DigiContact could not address all their support needs due to the distance, and that it was difficult for support workers to see beyond what they show and talk about (Zaagsma et al., 2021). The findings specifically underline the complexity of support contacts realised without video‐input. Not being able to register facial expressions and body language was felt to make it difficult to sort out a support users' true feelings. This matches with the writings of several authors on the challenges of providing remote care (e.g., Barbosa & Silva, 2017; Mallen et al., 2005; Rees & Stone, 2005), as described in the introduction. However, while it has been stressed that nonverbal communication is also relatively complex in video calls (Barbosa & Silva, 2017; Rees & Stone, 2005), the current study did not confirm this. Although the data did not provide information on this, it may be that the use of a half‐mirrored glass panel in front of the support workers' camera, which creates the impression of making direct eye contact, played a role in this.

In addition, the participants' work experiences were impacted by two support characteristics that are more specific to the DigiContact service. First, DigiContact support workers do not have contacts with a fixed subgroup of support users. As a consequence, they provide support to a very large and diverse group of people with intellectual disabilities. This was experienced to make the task of adopting a personalised approach in support relatively complex and resulted in support workers providing support as one team. This was experienced to lower the pressure of supporting such a large group of support users, as the responsibility was shared amongst all colleagues and there was always someone available for (practical and/or emotional) support. A parallel can be drawn with other studies that have shown that support from colleagues can be effective in helping workers in the field of intellectual disability services deal with work‐related stressors (e.g., Judd et al., 2017; Mutkins et al., 2011; Ryan et al., 2021; Vassos et al., 2017). However, providing support as one team was also experienced to make the job of DigiContact support workers more complex, as they had to find and invest in ways to collaborate well and to coordinate support plans and actions with all colleagues.

Second, the fact that support users can contact the DigiContact service without an appointment made the work of its support staff relatively unpredictable and contributed to fluctuations in the pace of incoming calls. Not knowing in advance who will call in and about what (and not being able to prepare oneself) was felt to be both challenging and exciting. Periods of being frequently faced with a continuous stream of incoming calls, left support workers with little to no time for relaxing and resetting their mind in between calls. Research has shown that a high workload is positively associated with symptoms of burnout amongst support workers (Gray‐Stanley & Muramatsu, 2011; Kowalski et al., 2010; Vassos & Nankervis, 2012). This association seems to be stronger when support workers experience little control over their workload (Vassos et al., 2017), as is the case with unplanned support contacts. Peer support (checking on each other, offering emotional support, enabling a colleague to take a break) is therefore of essential importance for DigiContact support staff, and should be regarded as an integrated part of the job that is facilitated by the organisation.

Limitations and future research

A substantial part of the identified distinctive aspects were related to the specific way the DigiContact service organises its support delivery. As a result, these aspects may not be recognisable to the support staff of other remote support services. For example, not every remote support service will give support users the possibility to call in without an appointment, and therefore not all remote support workers have to deal with the unpredictability that comes with unplanned contacts. However, the possibilities and challenges related to providing support from a distance might be recognisable for support staff of all remote support services. We recommend that future research focuses on exploring the experiences of support staff of other remote support services than DigiContact, in order to enable the identification and description of distinctive aspects of the work that are broadly recognisable.

Implications for practice

The findings of this study do not only contribute to an enhanced understanding of the specificities and complexities that can come with the task of providing remote professional support, but also indicate that there are organisational and professional preconditions that facilitate the task of providing good quality remote support. With regard to organisational preconditions, the findings underline the importance of a well‐functioning and quickly accessible digital information infrastructure (e.g., electronic client files), so that complete and up‐to‐date information on support users can be shared between onsite and remote support staff. In addition, as video calls are preferred over audio‐only calls in terms of being able to use different types of communication (also nonverbal), it seems advisable for organisations to promote and facilitate contacts with video input as much as possible, for example by offering support users the needed equipment (devices) on loan.

With regard to professional preconditions, the findings suggest that there are certain competencies that may be valuable for support staff working in remote support contexts. Service organisations can use such competencies to guide the recruitment, selection and training of (new) support staff. For instance, for DigiContact support workers it seems that having a wide set of knowledge and skills (both at the level of individual staff members as well as on the level of team composition), the ability to work both independently and in a team, and strong cognitive skills (e.g., sustained attention, speed of information processing, and cognitive flexibility) will be helpful for dealing with some of the complex aspects of their job. In addition, the findings indicate that having onsite work experience might help remote support workers to stay in touch with the background and complexity of the lives of some support users. This pleads for facilitating and stimulating remote support staff to also work some hours as a support worker in onsite settings. However, it is important to stress that almost all participants in this study (9 out of 10) had indeed worked as an onsite support worker before they started at the DigiContact service. We do not have enough empirical evidence regarding if remote support staff without onsite support experience feel like they miss this in their work.

CONFLICT OF INTEREST

The authors declare that the funder did not intervene in study design, the collection, analysis and interpretation of data, the writing of the report or the decision to submit the paper for publication. This study was conducted as part of the dissertation research project of the first author.