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Moecke DP, Holyk T, Beckett M, Chopra S, Petlitsyna P, Girt M, Kirkham A, Kamurasi I, Turner J, Sneddon D, Friesen M, McDonald I, Denson-Camp N, Crosbie S, Camp PG. Scoping review of telehealth use by Indigenous populations from Australia, Canada, New Zealand, and the United States. J Telemed Telecare 2024; 30:1398-1416. [PMID: 36911983 PMCID: PMC11411853 DOI: 10.1177/1357633x231158835] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Telehealth has the potential to address health disparities experienced by Indigenous people, especially in remote areas. This scoping review aims to map and characterize the existing evidence on telehealth use by Indigenous people and explore the key concepts for effective use, cultural safety, and building therapeutic relationships. METHODS A search for published and gray literature, written in English, and published between 2000 and 2022 was completed in 17 electronic databases. Two reviewers independently screened retrieved records for eligibility. For included articles, data were extracted, categorized, and analyzed. Synthesis of findings was performed narratively. RESULTS A total of 321 studies were included. The most popular type of telehealth used was mHealth (44%), and the most common health focuses of the telehealth interventions were mental health (26%) and diabetes/diabetic retinopathy (13%). Frequently described barriers to effective telehealth use included concerns about privacy/confidentiality and limited internet availability; meanwhile, telehealth-usage facilitators included cultural relevance and community engagement. Although working in collaboration with Indigenous communities was the most frequently reported way to achieve cultural safety, 40% of the studies did not report Indigenous involvement. Finally, difficulty to establish trusting therapeutic relationships was a major concern raised about telehealth, and evidence suggests that having the first visit-in-person is a potential way to address this issue. CONCLUSION This comprehensive review identified critical factors to guide the development of culturally-informed telehealth services to meet the needs of Indigenous people and to achieve equitable access and positive health outcomes.
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Affiliation(s)
- Débora Petry Moecke
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Travis Holyk
- Carrier Sekani Family Services, Prince George, Canada
| | - Madelaine Beckett
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Sunaina Chopra
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Mirha Girt
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | | | - Ivan Kamurasi
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Justin Turner
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Donovan Sneddon
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Ian McDonald
- University of British Columbia (UBC), Vancouver, Canada
| | | | | | - Pat G Camp
- University of British Columbia (UBC), Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Kabbes N, Bugra A, Wissanji H, Osmanlliu E. Telehealth for Indigenous Children Worldwide: A Scoping Review. J Pediatr Surg 2024; 59:908-917. [PMID: 38413263 DOI: 10.1016/j.jpedsurg.2024.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Indigenous children worldwide face healthcare disparities due, in part, to resource scarcity in remote settings which may be mitigated with technology. This study aims to determine the use of telehealth for this population, with respect to feasibility, acceptability, and the degree of patient/family involvement in reported interventions. We focused on the use of telehealth to support perioperative care. METHODS To identify relevant studies, five databases were searched to find articles that focused on the role of telehealth in caring for Indigenous populations worldwide, with an emphasis on the pediatric population. Studies that lacked insight into those themes, as well as protocols and review articles, were excluded. Analysis was done according to the non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework, the Montreal Model (patient involvement), and the theoretical framework of acceptability (TFA). RESULTS Of the 1690 articles screened, 34 met the eligibility criteria. The most frequent uses of telehealth for Indigenous children were in ENT and psychiatry. Most of those had a low degree of complexity across the NASSS framework domains, suggesting greater feasibility. In 13 articles, the patient involvement was limited to information (lowest level of involvement in the Montreal Model). Only 11 articles directly assessed patient/family-perceived acceptability. Finally, two articles addressed telehealth in the surgical context. CONCLUSIONS The relative simplicity of the proposed telehealth applications may support their sustained impact and use in other settings such as for perioperative care. Early and longitudinal involvement of communities is essential for responsible telehealth development that addresses local needs. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
- Nour Kabbes
- McGill Faculty of Medicine, Montreal, QC, Canada
| | - Adalet Bugra
- McGill Faculty of Medicine, Montreal, QC, Canada
| | - Hussein Wissanji
- Division of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.
| | - Esli Osmanlliu
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada; Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
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Jongebloed H, Anderson K, Winter N, Nguyen L, Huggins CE, Savira F, Cooper P, Yuen E, Peeters A, Rasmussen B, Reddy S, Crowe S, Bhoyroo R, Muhammad I, Ugalde A. The digital divide in rural and regional communities: a survey on the use of digital health technology and implications for supporting technology use. BMC Res Notes 2024; 17:90. [PMID: 38549176 PMCID: PMC10976777 DOI: 10.1186/s13104-024-06687-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/05/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE A digital divide exists for people from rural and regional areas where they are less likely and confident to engage in digital health technologies. The aim of this study was to evaluate the digital health literacy and engagement of people from rural and regional communities, with a focus on identifying barriers and facilitators to using technology. RESULTS Forty adults living in rural/regional areas completed a survey consisting of the eHealth Literacy Scale (eHEALS) with additional items surveying participants' experience with a range of digital health technologies. All participants had used at least one digital health technology. Most (80%) participants had an eHEALS score of 26 or above indicating confidence in online health information. Commonly reported barriers to digital health technology use centred on product complexity and reliability, awareness of resources, lack of trust, and cost. Effective digital health technology use is becoming increasingly important, there may be a need to prioritise and support people with lower levels of digital health literacy. We present opportunities to support community members in using and accessing digital health technology.
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Affiliation(s)
- Hannah Jongebloed
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia.
- School of Nursing & Midwifery, Faculty of Health, Deakin University, Geelong, Australia.
| | - Kate Anderson
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Computing Technologies, STEM College, RMIT University, Melbourne, Australia
- School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Natalie Winter
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Nursing & Midwifery, Faculty of Health, Deakin University, Geelong, Australia
| | - Lemai Nguyen
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- Deakin Business School, Faculty of Business and Law, Deakin University, Geelong, Australia
| | - Catherine E Huggins
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Feby Savira
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Health & Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Paul Cooper
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Eva Yuen
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Nursing & Midwifery, Faculty of Health, Deakin University, Geelong, Australia
| | - Anna Peeters
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
| | - Bodil Rasmussen
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Nursing & Midwifery, Faculty of Health, Deakin University, Geelong, Australia
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Sandeep Reddy
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Sarah Crowe
- Western Victoria Primary Health Network, Geelong, Australia
| | - Rahul Bhoyroo
- Western Victoria Primary Health Network, Geelong, Australia
| | - Imran Muhammad
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Medicine, Faculty of Health, Deakin University, Geelong, Australia
| | - Anna Ugalde
- Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, 3220, Australia
- School of Nursing & Midwifery, Faculty of Health, Deakin University, Geelong, Australia
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Wiley E, Sakakibara B, Park S, Barclay R, Bayley M, Eng JJ, Harris A, Inness E, MacKay-Lyons M, MacDermid J, Pollock C, Pooyania S, Teasell R, Yao J, Tang A. Exploring the experiences of an exercise-based telerehabilitation program among Canadian community-dwelling adults with stroke. Disabil Rehabil 2024:1-11. [PMID: 38361375 DOI: 10.1080/09638288.2024.2316772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE Telerehabilitation is emerging as a means for delivering stroke rehabilitation to address unmet lower extremity rehabilitation needs. However, there is currently limited and low-quality evidence supporting the use telerehabilitation interventions for lower extremity recovery after stroke. Thus, we developed an exercise-based telerehabilitation program (TRAIL) for safe and effective promotion of lower extremity function after stroke. This study reports on the qualitative findings from the feasibility study of the TRAIL program. METHODS An interpretive description methodology and inductive thematic analysis approach were undertaken. One-on-one semi-structured interviews were conducted on a subset of participants who completed the TRAIL feasibility study. Participants were recruited via email and enrolled into the study based on pre-determined purposeful sampling strategies. RESULTS Ten participants (6 men, 4 women) completed a semi-structured interview. Two main themes emerged: (i) TRAIL ingredients for success and (ii) telerehabilitation is a viable option for stroke rehabilitation. CONCLUSION Exercise-based telerehabilitation appears to be well-received by men and women post-stroke when social support, professional guidance, and program resources are offered. TRAIL may also prolong the continuum of care that individuals receive once they are discharged back into the community, and contribute to improvements in mobility, lower extremity strength and balance.
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Affiliation(s)
- Elise Wiley
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Brodie Sakakibara
- Department of Occupational Science & Occupational Therapy, Centre for Chronic Disease Prevention and Management, Southern Medical Program, University of British Columbia, Kelowna, BC, Canada
| | - Sarah Park
- School of Rehabilitation Sciences, University of British Columbia, Vancouver, British Columbia, BC, Canada
| | - Ruth Barclay
- Department of Physical Therapy, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Mark Bayley
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON
| | - Janice J Eng
- Department of Physical Therapy, University of British Columbia and Centre for Aging SMART at Vancouver Coastal Health, Vancouver, BC, Canada
- G.F Strong Rehabilitation Centre, Vancouver, BC, Canada
| | - Anne Harris
- G.F Strong Rehabilitation Centre, Vancouver, BC, Canada
| | - Elizabeth Inness
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Marilyn MacKay-Lyons
- School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Joy MacDermid
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- School of Physical Therapy, Western University, London, ON, Canada
| | - Courtney Pollock
- Department of Physical Therapy, University of British Columbia and Centre for Aging SMART at Vancouver Coastal Health, Vancouver, BC, Canada
| | - Sepideh Pooyania
- Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Robert Teasell
- Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, University of Western Ontario, ON, London
| | - Jennifer Yao
- G.F Strong Rehabilitation Centre, Vancouver, BC, Canada
- Department and Faculty of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
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Berger MN, Taba M, Marino JL, Lim MSC, Cooper SC, Lewis L, Albury K, Chung KSK, Bateson D, Skinner SR. Social media's role in support networks among LGBTQ adolescents: a qualitative study. Sex Health 2021; 18:421-431. [PMID: 34706814 DOI: 10.1071/sh21110] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/01/2021] [Indexed: 11/23/2022]
Abstract
Background Adolescents use social media more frequently than other age groups. Social media has been described as a safe environment for lesbian, gay, bisexual, transgender and queer and/or questioning (LGBTQ) adolescents. As part of mixed-methods research investigating the association between social networks and sexual agency, we present qualitative findings on how LGBTQ adolescents connect online to form support networks. Methods We recruited 30 adolescents aged 14-17years who identified as LGBTQ in terms of their gender or attraction in the longitudinal Social Networks and Agency Project. Semi-structured interviews were conducted online or face-to-face across Australia. Thematic analysis was used to explore perceptions and experiences of participants in relation to social media use and relationships. Results Two overarching themes were identified: LGBTQ adolescents use social media for identity, relationships and wellbeing support. Social media is not always free of discrimination for LGBTQ adolescents. Many LGBTQ participants joined Facebook groups to connect with LGBTQ peers. Facebook was considered a vital support for those with mental health concerns including suicidal ideation. Participants gave and received support from group members, which was considered useful for those feeling isolated or victimised. LGBTQ adolescents formed friendships, romantic relationships and gained information on sex, relationships, and sexual health from these groups. Participants described negative experiences including discrimination within Facebook groups, mismanaged groups and exposure to anti-LGBTQ sentiments. Conclusion Social media is an environment where LGBTQ adolescents can connect, educate and support each other, which may have beneficial effects for this marginalised group. There remain issues with social media including discrimination against and within LGBTQ communities.
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Affiliation(s)
- Matthew N Berger
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Melody Taba
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer L Marino
- University of Melbourne, Parkville, Vic., Australia; and Murdoch Children's Research Institute, Parkville, Vic., Australia; and Royal Women's Hospital, Parkville, Vic., Australia
| | - Megan S C Lim
- Murdoch Children's Research Institute, Parkville, Vic., Australia; and Burnet Institute, Melbourne, Vic., Australia; and Monash University, Melbourne, Vic., Australia
| | - Spring Chenoa Cooper
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Larissa Lewis
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; and The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Kath Albury
- Media and Communication, Swinburne University of Technology, Hawthorn, Vic., Australia
| | - Kon Shing Kenneth Chung
- School of Project Management, Faculty of Engineering, The University of Sydney, Sydney, NSW, Australia
| | - Deborah Bateson
- Family Planning NSW, Ashfield, NSW, Australia; and Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - S Rachel Skinner
- Speciality of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Classen B, Tudor K, du Preez E, Day E, Ioane J, Rodgers B. An Integrative Review of Contemporary Perspectives on Videoconference-Based Therapy-Prioritising Indigenous and Ethnic Minority Populations in the Global South. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2021; 6:545-558. [PMID: 33898737 PMCID: PMC8058578 DOI: 10.1007/s41347-021-00209-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/14/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022]
Abstract
An integrative literature review was undertaken as a means of drawing together contemporary perspectives on the outcomes and affordances of videoconference-based therapy. This review was conducted in a way which placed emphasis on the need for mental healthcare strategies which are mindful of the cultural and social needs of indigenous and ethnic minority populations, particularly those situated in the Global South. The review was undertaken using an inverse funnelling approach which sought to prioritise literature on videoconference-based therapy literature which specifically focused on indigenous and ethnic minority populations. A series of general and population specific searches across relevant health databases were supplemented by a simultaneous search of Google Scholar. The PICOS search tool was used in developing the search terms, and data was processed using an inductive approach to thematic analysis. A final dataset of 43 articles were included in the review. This body of literature encompassed an international range of studies and included perspectives informed by quantitative, qualitative and mixed methods research. Four key themes were identified across the reviewed literature: indigenous and ethnic minority populations, therapeutic relationships, clinical outcomes and technical and logistical considerations. Based on our findings, there is reason to believe that videoconference-based therapy can be made to be just as effective as offline, face-to-face modes of delivery. However, research into the efficacy, impact and cultural implications of this technology in relation to indigenous and ethnic minority populations represents a significant gap within contemporary literature.
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Affiliation(s)
- Ben Classen
- Auckland University of Technology, Auckland, New Zealand
| | - Keith Tudor
- Auckland University of Technology, Auckland, New Zealand
| | | | - Elizabeth Day
- Auckland University of Technology, Auckland, New Zealand
| | - Julia Ioane
- Auckland University of Technology, Auckland, New Zealand
| | - Brian Rodgers
- Auckland University of Technology, Auckland, New Zealand
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