JMIR Publications

ABSTRACT

Background:

Telehealth acceptability, feasibility, and quality data are lacking among adolescents and young adults (AYA) and their parents and caregivers (caregivers).

Objective:

To assess non-inferiority of telehealth vs in-person visits, comparing acceptability with respect to efficiency, effectiveness, equity, patient-centeredness, and confidentiality.

Methods:

Cross-sectional web-based survey sent to caregivers and AYA following video visits within an adolescent medicine subspecialty clinic, May-July, 2020. Proportions of AYA and caregivers who rated telehealth as non-inferior were compared using chi-square tests. Feasibility was assessed via items measuring technical difficulties. Deductive thematic analysis, using the Institute of Medicine (IOM) dimensions of healthcare quality, was used to code open-ended question responses.

Results:

Survey response rates were 20.5% (n=55) for AYA and 21.8% (n=123) for caregivers. The majority of 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 (22% vs 3%, p<0.01). One quarter of patients and 32% of caregivers reported technical difficulties. Dominant themes in qualitative data included advantages of telehealth for efficiency and equity of healthcare delivery. However, respondents’ concerns included reduced safety and effectiveness of care, particularly for patients with eating disorder, due to lack of hands-on exams, 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.