The Diffusion of Telehealth in Rural American Indian Communities: A Retrospective Survey of Key Stakeholders
The Diffusion of Telehealth in Rural American Indian Communities: A Retrospective Survey of Key Stakeholders
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DOI：
10.1089/tmj.2011.0076
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发表时间：
2012-01-01
影响因子：
4.7
通讯作者：
Shore, Jay H.
中科院分区：
文献类型：
--
作者：
Brooks, Elizabeth;Manson, Spero M.;Shore, Jay H.
目标：心理健康问题是许多美国印第安退伍军人严重关注的问题，特别是创伤后应激障碍和相关的精神疾病。然而，在土著社区获得心理健康治疗可能是一个挑战，因为那里基本上没有专门的服务。因此，远程医疗越来越多地被建议作为一种方式，以扩大医疗保健的保留地或附近。在这项研究中，我们想了解影响远程医疗诊所的扩散，提供精神卫生保健，农村，美国印第安退伍军人的因素。材料与方法：我们调查了39名参与决策过程、技术基础设施和三个诊所实施的关键人员和利益相关者。使用罗杰埃弗雷特的扩散理论作为一个框架，我们收集了有关具体任务的信息，阻碍进展的因素，以及个人对远程医疗实施前后的反应。结果：许多参与者表示最初的关注使用远程保健，但是，随着时间的推移，大多数人变得积极。影响参与者观点的因素主要包括患者和工作人员的反馈以及见证社区健康需求的实现。利用外部信息来支持诊所的实施和个人冠军也对诊所的成功产生了相当大的影响。结论：这里提出的研究结果解决了我们对远程医疗传播的理解中的关键差距，并为有关远程医疗服务的文化问题和成果的研究策略提供了信息。本报告所载的信息作为一个长期的指导发展远程健康计划和政策之间的美洲印第安人，特别是农村人口一般。
Objective: Mental health issues are a serious concern for many American Indian Veterans, especially for post-traumatic stress disorder and related psychiatric conditions. Yet, acquiring mental health treatment can be a challenge in Native communities where specialized services are largely unavailable. Consequently, telehealth is increasingly being suggested as a way to expand healthcare access on or near reservation lands. In this study, we wanted to understand the factors affecting the diffusion of telehealth clinics that provided mental health care to rural, American Indian Veterans. Materials and Methods: We surveyed 39 key personnel and stakeholders who were involved in the decision-making process, technological infrastructure, and implementation of three clinics. Using Roger Everett's Diffusion Theory as a framework, we gathered information about specific tasks, factors hindering progress, and personal reactions to telehealth both before and after implementation. Results: Many participants expressed initial concerns about using telehealth; however, most became positive over time. Factors that influenced participants' viewpoint largely included patient and staff feedback and witnessing the fulfillment of a community health need. The use of outside information to support the implementation of the clinics and personal champions also showed considerable influence in the clinics' success. Conclusion: The findings presented here address critical gaps in our understanding of telehealth diffusion and inform research strategies regarding the cultural issues and outcomes related to telemental health services. Information contained in this report serves as a long overdue guide for developing telemental health programs and policies among American Indians, specifically, and rural populations in general.