Child Health and Telehealth in Global, Underresourced Settings

Hsing, Julianna C.; Wang, C. Jason; Wise, Paul H.

doi:10.1016/j.pcl.2020.04.014

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…While some research has shown that telehealth in IPC may increase access to care by addressing logistical barriers (e.g., decreasing missed work or school, reducing traveling costs or limitations) faced by traditionally underserved groups ( Nelson et al, 2017 ), other disparities may become more pronounced with telehealth for those with limited resources ( Hsing et al, 2020 ). Community survey data show that most families in the U.S. report ownership of at least one smart device ( Jeong et al, 2018 ), suggesting that most families could potentially access telehealth services.…”

Section: Role Of Ipc and Telehealth In Access To Care During The Pandemicmentioning

confidence: 99%

COVID-19, Telehealth, and Pediatric Integrated Primary Care: Disparities in Service Use

Chakawa

Belzer

Perez-Crawford

2021

Journal of Pediatric Psychology

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Objective The coronavirus disease 2019 pandemic (COVID-19) may increase pediatric mental health needs due to its social, economic, and public health threats, especially among Black, Indigenous, and People of Color and those served within disadvantaged communities. COVID-19 protocols have resulted in increased provision of telehealth in integrated primary care (IPC) but little is known about pediatric telehealth IPC utilization during the pandemic for diverse and traditionally underserved groups. Methods A comparative study was conducted to explore variability between in-person (pre-COVID-19; n = 106) and telehealth (mid-COVID-19; n = 120) IPC consultation utilization among children 1–19 years old served through a large, inner-city primary care clinic. Logistic regression modeling was used to examine the association between service delivery modality (i.e., in-person vs. telehealth) and attendance, referral concerns, and several sociodemographic variables. Results Service delivery modality and attendance, referral concerns, and race/ethnicity were significantly associated. The odds of non-attendance were greater for children scheduled for telehealth, the odds of children with internalizing problems being scheduled for telehealth were greater than those with externalizing problems, and the odds of Black children being scheduled for telehealth were less compared to White children. Conclusion Though telehealth has helped provide IPC continuity during COVID-19, findings from this study show troubling preliminary data regarding reduced attendance, increased internalizing concerns, and disparities in scheduling for Black patients. Specific actions to monitor and address these early but alarming indications of telehealth and Covid-19 related behavioral health disparities are discussed.

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Section: Role Of Ipc and Telehealth In Access To Care During The Pandemicmentioning

confidence: 99%

COVID-19, Telehealth, and Pediatric Integrated Primary Care: Disparities in Service Use

Chakawa

Belzer

Perez-Crawford

2021

Journal of Pediatric Psychology

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“…Interventions delivered via telehealth improve access, generalizability and scalability of care (19). With technologybased interventions, treatment can be offered to youth in their homes, obviating the need to travel to distant clinical locations to receive subspecialty care.…”

Section: Introductionmentioning

confidence: 99%

Pilot Study of Telehealth Delivered Rehabilitative Exercise for Youth With Concussion: The Mobile Subthreshold Exercise Program (MSTEP)

et al. 2021

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Background: Concussion is common, and up to 30% of youth develop persistent symptoms. Preliminary data suggests treatment with rehabilitative exercise is beneficial, but most programs require frequent in-person visits, which is challenging for youth in rural areas, and has been made more difficult for all youth during the COVID-19 pandemic. We have adapted an exercise intervention to be delivered via telehealth using Zoom and personal fitness devices, which could ensure access to this type of treatment.Objective: The goal of this study was to assess feasibility and acceptability of a telehealth delivered exercise intervention for concussion, the Mobile Subthreshold Exercise Program (MSTEP), and collect pilot data regarding efficacy.Materials and Methods: All youth received the 6-week MSTEP intervention which included wearing a Fitbit and setting exercise heartrate and duration goals weekly over Zoom with the research assistant. Youth completed standardized measures of concussive symptoms (Health Behavior Inventory, HBI), fear-avoidance (Fear of Pain Questionnaire, FOPQ) and health-related quality of life (Pediatric Quality of life Assessment, PedsQL), as well as a structured qualitative exit interview. We examined change in measures over time using mixed effects modeling, controlling for age, sex, prior concussion and duration of symptoms. We coded qualitative interviews using Thematic analysis.Results: We recruited 19 subjects, 79% female with average age 14.3 (SD 2.2) and mean duration of symptoms 75.6 days (SD 33.7). Participants wore the Fitbit on 80% of days, and completed 94% of surveys and 96% of Zoom calls. Concussive symptoms (HBI) decreased significantly over the 6 week intervention (−10.6, 95%CI: −16.0 to −5.1) as did fear-avoidance (−21.6, 95%CI: −29.8 to −13.5). PedsQL improved significantly during the same time period (+15.1, 95%CI: 8.6–21.6). Approximately three-quarters (76%) of youth rated their care as “excellent.” Participants appreciated the structure of the guided exercise program and the support of the RA. They also enjoyed being able to track their progress with the Fitbit.Conclusion: This study provides evidence for the feasibility and acceptability of a telehealth delivered rehabilitative exercise intervention for youth with concussion. Further research utilizing a randomized controlled trial is needed to assess efficacy.Clinical Trial Registration:https://clinicaltrials.gov, identifier: NCT03691363. https://clinicaltrials.gov/ct2/show/NCT03691363

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“…La telesalud en pediatría es un concepto amplio que engloba teleconsulta, telediagnóstico, teletratamiento, telemonitorización y teleasistencia; y se basa en el uso de cualquier tecnología de la información que, enriquecida con datos, algoritmos o patrones, puede satisfacer las necesidades de salud de cada paciente (3,4). Pero no es solamente una herramienta de servicio individual, la telesalud, incluida la salud móvil (mHealth por sus siglas en inglés), puede monitorear las intervenciones en salud pública, facilitar espacios de colaboración y formación entre profesionales de la salud y muchas veces se comporta como un faro de opciones de autocuidado.…”

Section: Entorno Digital Para La Salud Infantil Personalizada Telesaludunclassified

Ecosistemas de salud en pediatría

Izquierdo

Jiménez

2022

Med.

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Las inversiones tempranas en la salud, la educación y el desarrollo de los niños tienen beneficios que se acumulan a lo largo de la vida, para sus futuros hijos y para la sociedad en su conjunto. Las sociedades exitosas invierten en sus niños y protegen sus derechos, como es evidente en los países que aplican eficientemente las medidas sanitarias y económicas durante las últimas décadas. Sin embargo, muchas decisiones políticas todavía no dan prioridad a la inversión en la infancia ni la perciben como la base para mejoras sociales. Incluso, en los países ricos, muchos niños pasan hambre o viven en condiciones de pobreza absoluta, especialmente los que pertenecen a grupos sociales marginados, incluidas las poblaciones indígenas y las minorías étnicas. Además, muchos millones de niños crecen marcados por la guerra o la inseguridad, excluidos de recibir los servicios de salud, educación y desarrollos más básicos. El modelo actual del sistema de salud colombiano es lineal y, por su diseño derrochador, con pocas oportunidades de aprender y mejorar. La necesidad de integrar los sistemas de salud y atención médica en una ecoestructura cohesiva permite que las empresas de atención médica se adapten, respondan y aprendan constantemente del ecosistema de salud. El desarrollo de una tecnología adecuada con sistemas de inteligencia artificial, mejorará la prestación de servicios de salud en la población de manera dinámica y receptiva para transformar la prestación de servicios de salud, que en el esquema actual opera como un sistema reactivo, y pasar a uno proactivo, en especial cuando se trata de la atención médica en pediatría.

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Child Health and Telehealth in Global, Underresourced Settings

Cited by 4 publications

References 16 publications

COVID-19, Telehealth, and Pediatric Integrated Primary Care: Disparities in Service Use

COVID-19, Telehealth, and Pediatric Integrated Primary Care: Disparities in Service Use

Pilot Study of Telehealth Delivered Rehabilitative Exercise for Youth With Concussion: The Mobile Subthreshold Exercise Program (MSTEP)

Ecosistemas de salud en pediatría

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