Development and validation of the telemedicine facilitators scale: A novel measure of telemedicine facilitators and use

Abstract

The COVID-19 pandemic resulted in a dramatic increase in the use of telemedicine, with heightened rates of use persisting postpandemic. This change in use created a need for a valid and reliable scale to assess telemedicine use and facilitators impacting its uptake. The current study developed and validated the Telemedicine Facilitators Scale (TFS), a novel measure for assessing facilitators of telemedicine uptake. A sample of 228 physicians completed 13 items for the TFS along with an index of telemedicine use for convergent validity. We conducted two confirmatory factor analysis (CFA) models testing a four-factor structure (Positive Attitudes, Facilitating Infrastructure, Organizational Support, and External Policies) and a bifactor model in which all items loaded onto to a single telemedicine facilitators factor and the previous four factors. Both the four-factor CFA and bifactor models demonstrated acceptable fit for χ²/degrees of freedom, comparative fit index, and incremental fit index. The correlations among subscales showed that each subscale, while related, measured independent constructs. Both the general telemedicine facilitators factor and all four subfactors were positively correlated with telemedicine use, evidencing good convergent validity. Results suggest that the TFS may be used as a four-factor scale, a unidimensional scale, or a scale composed of both an overarching construct and four subconstructs. The TFS represents a useful tool for researchers, clinicians, and healthcare administrators who wish to study, use, or facilitate the use and evolution of telemedicine.