Date Presented 04/21/2023
This study aimed to describe the clinical use of telehealth by U.S. pediatric OTs, identify usage barriers, evaluate predictors of intention to use telehealth, and determine therapists’ learning needs. The results indicated that OTs with 6 to 10 years of clinical experience have the highest self-efficacy about using telehealth. The other variables (participant’s age, education level, client age range) yielded no interaction effects. Future studies should focus more on this area.
Primary Author and Speaker: Chiao-Ju Fang
Contributing Authors: Richard Broyer, Julian Park, Sarah Saturday, Mei-Heng Wu, Morgan Cash, Natalie Pridmore
PURPOSE: Due to the COVID-19 pandemic, many healthcare practitioners have switched to telehealth, making it crucial to understand how to train practitioners to give care remotely. While evidence supports the efficacy of pediatric occupational therapists’ telehealth services, little is known about how to train pediatric OTs to implement telehealth services effectively. In addition, some practitioners are concerned that telehealth leads to lower care quality. However, many practitioners hold favorable opinions about telehealth. This study aimed to describe the clinical use of telehealth by U.S. pediatric OTs, identify usage barriers, evaluate predictors of intention to use telehealth, and determine therapists’ learning needs.
DESIGN: This was a descriptive and mixed-method survey study. Participants completed a survey instrument. The results were used to categorize the current clinical uses, learning needs, and preferences of telehealth in pediatric occupational therapy. In addition, the survey included rating scale questions for determining attitude composite and social norms and open-ended questions to assess perceived behavioral control and behavioral intention for telehealth use. The population of interest was current pediatric occupational therapists practicing in the United States. Participants were gathered using a snowball sampling method.
METHOD: A sample of 135 pediatric OTs completed the Assessing Determinants of Prospective Take-up of Telehealth (ADPTT) instrument. Descriptive statistics, linear regression, and qualitative data analysis were used to determine variables that influence behavioral intention and usage of telehealth.
RESULTS: OTs’ self-efficacy and years of clinical experience were significantly correlated. Additionally, their age (b = 0.28, p < 0.05), attitudes (b = 0.43, p < 0.05), compatibility (b = 0.37, p < 0.05), social norms (b = 0.31, p < 0.05), and peer influences (b = 0.32, p < 0.05) positively predicted intention to use telehealth, and explained 65.4% of the variance in behavioral intentions. Qualitative data identified themes in barriers to telehealth implementation: lack of physical touch and client engagement; and facilitators to telehealth implementation: the COVID-19 pandemic, providing services in clients’ natural environments and increased access to care.
CONCLUSION: The results align with previous studies regarding the association between pediatric OTs’ clinical experience and self-efficacy. Understanding therapists’ attitudes and social influences leading them to choose telehealth is essential for developing initiatives to support the clinical integration of telehealth. Future studies should look into a link between telehealth experience and self-efficacy. For future pediatric OT practice, there is a need for a more standardized model of telehealth service delivery that offers support and training for both new and more experienced clini.
References
American Occupational Therapy Association (AOTA). (2021, February 19). COVID-19 state updates: Summary of telehealth, insurance, and licensure developments; and comprehensive state-by-state chart. https://www.aota.org/Advocacy-Policy/State-Policy/StateNews/2020/COVID-19-Summary-Telehealth-Insurance-Licensure.aspx
Benfield, J. A. & Szlemko, W. J. (2006). Internet-based data collection: Promises and realities. Journal of Research Practice, 2(2). http://jrp.icaap.org/index.php/jrp/article/view/30/51
Cason, J. (2011). Telerehabilitation: An adjunct service delivery model for early intervention services. International Journal of Telerehabilitation, 3(1), 19. https://doi.org/10.5195/ijt.2011.6071
Cason, J., & Ringwalt, S. (2012). Overview of states’ use of telehealth for the delivery of early intervention (IDEA Part C) services. International Journal of Telerehabilitation, 4(2), 39–45. https://doi.org/10.5195/ijt.2012.6105
