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      People’s Experiences and Satisfaction With Telehealth During the COVID-19 Pandemic in Australia: Cross-Sectional Survey Study

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          Abstract

          Background

          In response to the COVID-19 pandemic, telehealth has rapidly been adopted to deliver health care services around the world. To date, studies have not compared people’s experiences with telehealth services during the pandemic in Australia to their experiences with traditional in-person visits.

          Objective

          This study aimed to compare participants’ perceptions of telehealth consults to their perceptions of traditional in-person visits and investigate whether people believe that telehealth services would be useful after the pandemic.

          Methods

          A national, cross-sectional, community survey was conducted between June 5 and June 12, 2020 in Australia. In total, 1369 participants who were aged ≥18 years and lived in Australia were recruited via targeted advertisements on social media (ie, Facebook and Instagram). Participants responded to survey questions about their telehealth experience, which included a free-text response option. A generalized linear model was used to estimate the adjusted relative risks of having a poorer telehealth experience than a traditional in-person visit experience. Content analysis was performed to determine the reasons why telehealth experiences were worse than traditional in-person visit experiences.

          Results

          Of the 596 telehealth users, the majority of respondents (n=369, 61.9%) stated that their telehealth experience was “just as good as” or “better than” their traditional in-person medical appointment experience. On average, respondents perceived that telehealth would be moderately useful to very useful for medical appointments after the COVID-19 pandemic ends (mean 3.67, SD 1.1). Being male ( P=.007), having a history of both depression and anxiety ( P=.016), and lower patient activation scores (ie, individuals’ willingness to take on the role of managing their health/health care) ( P=.036) were significantly associated with a poor telehealth experience. In total, 6 overarching themes were identified from free-text responses for why participants’ telehealth experiences were poorer than their traditional in-person medical appointment experiences, as follows: communication is not as effective, limitations with technology, issues with obtaining prescriptions and pathology results, reduced confidence in their doctor, additional burden for complex care, and inability to be physically examined.

          Conclusions

          Based on our sample’s responses, telehealth appointment experiences were comparable to traditional in-person medical appointment experiences. Telehealth may be worthwhile as a mode of health care delivery while the pandemic continues, and it may continue to be worthwhile after the pandemic.

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          Most cited references30

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          The Measurement of Observer Agreement for Categorical Data

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            The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence

            Background The outbreak of coronavirus disease-19 (COVID-19) is a public health emergency of international concern. Telehealth is an effective option to fight the outbreak of COVID-19. The aim of this systematic review was to identify the role of telehealth services in preventing, diagnosing, treating, and controlling diseases during COVID-19 outbreak. Methods This systematic review was conducted through searching five databases including PubMed, Scopus, Embase, Web of Science, and Science Direct. Inclusion criteria included studies clearly defining any use of telehealth services in all aspects of health care during COVID-19 outbreak, published from December 31, 2019, written in English language and published in peer reviewed journals. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies. Quality assessment was based on the Critical Appraisal Skills Program (CASP) checklist. Narrative synthesis was undertaken to summarize and report the findings. Results Eight studies met the inclusion out of the 142 search results. Currently, healthcare providers and patients who are self-isolating, telehealth is certainly appropriate in minimizing the risk of COVID-19 transmission. This solution has the potential to prevent any sort of direct physical contact, provide continuous care to the community, and finally reduce morbidity and mortality in COVID-19 outbreak. Conclusions The use of telehealth improves the provision of health services. Therefore, telehealth should be an important tool in caring services while keeping patients and health providers safe during COVID-19 outbreak.
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              eHEALS: The eHealth Literacy Scale

              Background Electronic health resources are helpful only when people are able to use them, yet there remain few tools available to assess consumers’ capacity for engaging in eHealth. Over 40% of US and Canadian adults have low basic literacy levels, suggesting that eHealth resources are likely to be inaccessible to large segments of the population. Using information technology for health requires eHealth literacy—the ability to read, use computers, search for information, understand health information, and put it into context. The eHealth Literacy Scale (eHEALS) was designed (1) to assess consumers’ perceived skills at using information technology for health and (2) to aid in determining the fit between eHealth programs and consumers. Objectives The eHEALS is an 8-item measure of eHealth literacy developed to measure consumers’ combined knowledge, comfort, and perceived skills at finding, evaluating, and applying electronic health information to health problems. The objective of the study was to psychometrically evaluate the properties of the eHEALS within a population context. A youth population was chosen as the focus for the initial development primarily because they have high levels of eHealth use and familiarity with information technology tools. Methods Data were collected at baseline, post-intervention, and 3- and 6-month follow-up using control group data as part of a single session, randomized intervention trial evaluating Web-based eHealth programs. Scale reliability was tested using item analysis for internal consistency (coefficient alpha) and test-retest reliability estimates. Principal components factor analysis was used to determine the theoretical fit of the measures with the data. Results A total of 664 participants (370 boys; 294 girls) aged 13 to 21 (mean = 14.95; SD = 1.24) completed the eHEALS at four time points over 6 months. Item analysis was performed on the 8-item scale at baseline, producing a tight fitting scale with α = .88. Item-scale correlations ranged from r = .51 to .76. Test-retest reliability showed modest stability over time from baseline to 6-month follow-up (r = .68 to .40). Principal components analysis produced a single factor solution (56% of variance). Factor loadings ranged from .60 to .84 among the 8 items. Conclusions The eHEALS reliably and consistently captures the eHealth literacy concept in repeated administrations, showing promise as tool for assessing consumer comfort and skill in using information technology for health. Within a clinical environment, the eHEALS has the potential to serve as a means of identifying those who may or may not benefit from referrals to an eHealth intervention or resource. Further research needs to examine the applicability of the eHEALS to other populations and settings while exploring the relationship between eHealth literacy and health care outcomes.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                December 2020
                10 December 2020
                10 December 2020
                : 22
                : 12
                : e24531
                Affiliations
                [1 ] Faculty of Medicine and Health Sydney Health Literacy Lab, School of Public Health The University of Sydney Sydney Australia
                [2 ] Population Wellbeing and Environment Research Lab School of Health and Society University of Wollongong Wollongong Australia
                [3 ] Western Sydney Diabetes Western Sydney Local Health District Sydney Australia
                Author notes
                Corresponding Author: Jennifer MJ Isautier jennifer.isautier@ 123456sydney.edu.au
                Author information
                https://orcid.org/0000-0002-6376-680X
                https://orcid.org/0000-0001-7801-5884
                https://orcid.org/0000-0002-5279-5189
                https://orcid.org/0000-0002-6043-6071
                https://orcid.org/0000-0002-1156-9345
                https://orcid.org/0000-0003-1896-533X
                https://orcid.org/0000-0002-4797-6460
                https://orcid.org/0000-0002-8080-6359
                https://orcid.org/0000-0002-8100-4278
                https://orcid.org/0000-0002-1621-3217
                https://orcid.org/0000-0003-4944-7826
                https://orcid.org/0000-0003-4452-1863
                https://orcid.org/0000-0003-2696-5006
                Article
                v22i12e24531
                10.2196/24531
                7732356
                33156806
                ca35a7f3-cfbf-4e2b-8a8e-3056214a08bd
                ©Jennifer MJ Isautier, Tessa Copp, Julie Ayre, Erin Cvejic, Gideon Meyerowitz-Katz, Carys Batcup, Carissa Bonner, Rachael Dodd, Brooke Nickel, Kristen Pickles, Samuel Cornell, Thomas Dakin, Kirsten J McCaffery. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 10.12.2020.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 23 September 2020
                : 6 October 2020
                : 25 October 2020
                : 31 October 2020
                Categories
                Original Paper
                Original Paper

                Medicine
                covid-19,patient experience,telehealth,experience,satisfaction,telemedicine,australia,usability,cross-sectional,survey

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