Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 25, 2023
Date Accepted: Nov 5, 2023
Implementation Considerations for Family-based Telehealth Interventions for Youth in Foster Care: A Qualitative Study
ABSTRACT
Background:
Many barriers exist for foster youth with mental health challenges to participate in therapeutic family-based interventions.
Objective:
The aim of this study was to understand child welfare system stakeholders’ perspectives on enabling factors and barriers to providing family-based interventions via telehealth to youth in out-of-county foster care placement.
Methods:
This qualitative study derived themes from three focus groups with 6 or 7 child welfare stakeholders per group. Data was analyzed using constant comparative analysis and inductive thematic analysis.
Results:
Participants were 19 child welfare system stakeholders (e.g., social workers, residential treatment staff, supervisors) who participated in one of three focus groups. Most system stakeholders (N=19, 6-7/group) were women (68%), white (53%), and social workers (42%). On average, stakeholders worked in the child welfare system for 16.6 (SD=8.3) years. Stakeholders identified multi-level factors impacting family-based intervention delivery including environmental (e.g., Medicare billing, presumptive transfer), predisposing characteristics (e.g., psychological resources), enabling factors (e.g., transportation, team-based youth-centered care) and need factors (e.g., motivation to engage). Stakeholders expressed optimism that telehealth could increase access to needed mental health care, diverse providers and longevity of care while also expressing some concerns regarding telehealth access and literacy.
Conclusions:
Child welfare system stakeholders’ highlight the need for policies and telehealth interventions that are youth- versus placement-centered, include resources that limit barriers and bolster motivation for engagement, and follow a team-based care model. Clinical Trial: ClinicalTrials.gov; Identifier: NCT04488523; https://clinicaltrials.gov/ct2/show/NCT04488523
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