TY  - JOUR
AU  - Wood, Sarah M
AU  - Pickel, Julia
AU  - Phillips, Alexis W
AU  - Baber, Kari
AU  - Chuo, John
AU  - Maleki, Pegah
AU  - Faust, Haley L
AU  - Petsis, Danielle
AU  - Apple, Danielle E
AU  - Dowshen, Nadia
AU  - Schwartz, Lisa A
PY  - 2021
DA  - 2021/11/15
TI  - Acceptability, Feasibility, and Quality of Telehealth for Adolescent Health Care Delivery During the COVID-19 Pandemic: Cross-sectional Study of Patient and Family Experiences
JO  - JMIR Pediatr Parent
SP  - e32708
VL  - 4
IS  - 4
KW  - telehealth
KW  - telemedicine
KW  - adolescent
KW  - COVID-19
KW  - acceptability
KW  - feasibility
KW  - young adult
KW  - teenager
KW  - cross-sectional
KW  - patient experience
KW  - experience
KW  - efficiency
KW  - equity
KW  - survey
AB  - Background: Data regarding the acceptability, feasibility, and quality of telehealth among adolescents and young adults (AYA) and their parents and caregivers (caregivers) are lacking. Objective: The aim of this study was to assess the noninferiority of telehealth versus in-person visits by comparing acceptability with respect to efficiency, effectiveness, equity, patient-centeredness, and confidentiality. Methods: Cross-sectional web-based surveys were sent to caregivers and AYA following video visits within an Adolescent Medicine subspecialty clinic in May-July 2020. Proportions of AYA and caregivers who rated telehealth as noninferior were compared using chi-squared tests. Feasibility was assessed via items measuring technical difficulties. Deductive thematic analysis using the Institute of Medicine dimensions of health care quality was used to code open-ended question responses. Results: Survey response rates were 20.5% (55/268) for AYA and 21.8% (123/563) for caregivers. The majority of the respondents were White cisgender females. Most AYA and caregivers rated telehealth as noninferior to in-person visits with respect to confidentiality, communication, medication management, and mental health care. A higher proportion of AYA compared to caregivers found telehealth inferior with respect to confidentiality (11/51, 22% vs 3/118, 2.5%, P<.001). One-quarter (14/55) of the AYA patients and 31.7% (39/123) of the caregivers reported technical difficulties. The dominant themes in the qualitative data included advantages of telehealth for efficiency and equity of health care delivery. However, respondents’ concerns included reduced safety and effectiveness of care, particularly for patients with eating disorders, owing to lack of hands-on examinations, collection of vital signs, and laboratory testing. Conclusions: Telehealth was highly acceptable among AYA and caregivers. Future optimization should include improving privacy, ameliorating technical difficulties, and standardizing at-home methods of obtaining patient data to assure patient safety. 
SN  - 2561-6722
UR  - https://pediatrics.jmir.org/2021/4/e32708
UR  - https://doi.org/10.2196/32708
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34779782
DO  - 10.2196/32708
ID  - info:doi/10.2196/32708
ER  -