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IntroductionTelehealth became the most practical option for general practice consultations in Aotearoa New Zealand (NZ) as a result of the national lockdowns in response to the COVID-19 pandemic. What is the consumer experience of access to telehealth and how do consumers and providers perceive this mode of care delivery going forward?Methods and analysisA national survey of general practice consumers and providers who used telehealth services since the national lockdowns in 2020 will be distributed. It is based on the Unified Theory of Acceptance and Use of Technology framework of technology acceptance and the access to care framework. The data will be statistically analysed to create a foundation for in-depth research on the use of telehealth services in NZ general practice services, with a specific focus on consumer experiences and health outcomes.Ethics and disseminationEthics approval was granted by the Auckland Health Research Ethics Committee on 13/11/2020, reference AH2539. The survey will be disseminated online.

Background Telehealth is often suggested to improve access to health care and has had significant publicity worldwide during the COVID-19 pandemic. However, limited studies have examined the telehealth needs of underserved populations such as rural communities. Objective This study aims to investigate enablers for telehealth use in underserved rural populations to improve access to health care for rural older adults. Methods In total, 7 focus group discussions and 13 individual interviews were held across 4 diverse underserved rural communities. A total of 98 adults aged ≥55 years participated. The participants were asked whether they had used telehealth, how they saw their community’s health service needs evolving, how telehealth might help provide these services, and how they perceived barriers to and enablers of telehealth for older adults in rural communities. Focus group transcripts were thematically analyzed. Results The term telehealth was not initially understood by many participants and required an explanation. Those who had used telehealth reported positive experiences (time and cost savings) and were likely to use telehealth again. A total of 2 main themes were identified through an equity lens. The first theme was trust, with 3 subthemes—trust in the telehealth technology, trust in the user (consumer and health provider), and trust in the health system. Having access to reliable and affordable internet connectivity and digital devices was a key enabler for telehealth use. Most rural areas had intermittent and unreliable internet connectivity. Another key enabler is easy access to user support. Trust in the health system focused on waiting times, lack of and/or delayed communication and coordination, and cost. The second theme was choice, with 3 subthemes—health service access, consultation type, and telehealth deployment. Access to health services through telehealth needs to be culturally appropriate and enable access to currently limited or absent services such as mental health and specialist services. Accessing specialist care through telehealth was extremely popular, although some participants preferred to be seen in person. A major enabler for telehealth was telehealth deployment by a fixed community hub or on a mobile bus, with support available, particularly when combined with non–health-related services such as internet banking. Conclusions Overall, participants were keen on the idea of telehealth. Several barriers and enablers were identified, particularly trust and choice. The term telehealth is not well understood. The unreliable and expensive connectivity options available to rural communities have limited telehealth experience to phone or patient portal use for those with connectivity. Having the opportunity to try telehealth, particularly by using video, would increase the understanding and acceptance of telehealth. This study highlights that local rural communities need to be involved in designing telehealth services within their communities.

Sponsoring has been positioned as a powerful intervention for the career advancement of women, with career resilience as a key benefit of sponsorship. In this paper we utilise a psychoanalytic framework namely Lacanian discourse theory, to argue that this may not be the case, and that sponsoring may actually create a diagonally opposite result by creating (ir)resilience in individuals being sponsored. Our theoretical critique is supported by empirical data from qualitative interviews with participants across Europe, as well as an examination of extracts from accounts of sponsoring in published research. Our analysis supports an alternate way of thinking about sponsoring and has implications for human resource practice. We suggest reversing the hierarchical positioning of sponsors and sponsees to counter the (ir)resilience created in a hierarchical sponsoring relationship. The resulting artificially introduced hystericisation will set the scene for radical change and build career resilience in women, both as sponsors and sponsees.

BACKGROUND Telehealth is often suggested to improve access to healthcare and has had significant publicity internationally during the Covid-19 pandemic. However, there is limited research examining the telehealth needs of underserved populations such as rural communities. OBJECTIVE The aim of this study was to investigate enablers for telehealth use in rural underserved populations to improve access to healthcare for rural older adults. METHODS 7 focus group discussions and 13 individual interviews were held across 4 diverse underserved rural communities. 98 adults, aged 55 years and over, participated. Participants were asked if they had used telehealth, how they saw their community’s health service needs evolving, how telehealth might help provide these services, and perceived barriers and enablers to telehealth for older adults in rural communities. Focus group transcripts were thematically analysed. RESULTS The term ‘telehealth’ was not initially understood by many participants and required explanation. The likelihood of using telehealth varied between those who had used telehealth and those who had not. Those who had used telehealth reported very positive experiences (time and cost savings) and would be more likely to use telehealth again. Two main themes were identified through an equity lens. The first theme was “trust” with three sub-themes – trust in the telehealth technology, trust in the user (consumer and health provider) and trust in the health system. Having access to reliable and affordable internet connectivity and digital devices was a key enabler for telehealth use. Most rural areas had intermittent, unreliable internet connectivity. Having easy access to user support was another key enabler. Trust in the health system focused on waiting times, lack of/delayed communication and coordination, and cost. The second theme was “choice” with three sub-themes – health service access, consultation type and telehealth deployment. Access to health services by telehealth needs to be culturally appropriate and enable access to currently limited or absent services such as mental health and specialist services. Accessing specialist care by telehealth was extremely popular but some participants would rather be seen in person. A major enabler for telehealth was deploying telehealth by a fixed community ‘hub’ or on a mobile bus, with support available, and especially when combined with non-health related services such as online banking. CONCLUSIONS Overall, participants were keen on the idea of telehealth. Several barriers and enablers were identified. The term ‘telehealth’ is not well understood. The unreliable and expensive connectivity options available to the rural communities has limited the telehealth experience to phone or patient portal use, for those who have connectivity. Having the opportunity to try telehealth, especially using video, would increase understanding and acceptance of telehealth. The study highlights that local rural communities need to be involved in the design of telehealth services within their community.