Parent Satisfaction With a Telehealth Coaching Program for Families of Children With Special Health Care Needs

PURPOSE: The Coronavirus pandemic required occupational therapy (OT) practitioners to rapidly uptake telehealth intervention approaches. Research evaluating telehealth OT outcomes is necessary to examine specifically if, how, and for whom this approach is most effective. The purpose of this study was to examine parent satisfaction and perceptions of the telehealth approach of a parent coaching intervention designed to improve family occupational participation, adaptability, and cohesion for families of children with special healthcare needs (CSHCN). The research questions were: 1) what are parents’ satisfaction levels and experiences with the telehealth approach of an occupation-based parent coaching intervention, and 2) what is the relationship between parent satisfaction with telehealth and demographic variables?

DESIGN: This study used a mixed methods descriptive design. Participants (N = 15) were recruited via convenience sampling using social media postings and emails to professional networks. Participants were parents of CSHCN ages 2-17, who had an internet accessible Zoom-capable device, and who spoke English. A CSHCN was defined as a child with, or at risk for, a chronic physical, developmental, emotional, or behavioral condition requiring more supportive services of a type or amount beyond that required by children generally (McPherson et al.,1998).

METHOD: Participants completed the Telehealth Usability Questionnaire (TUQ) (Parmanto et al., 2016) after the intervention to measure satisfaction with telehealth. The TUQ is a 21-item seven point Likert scale that assesses perceptions of telehealth in five areas: usefulness, ease of use, effectiveness, reliability, and satisfaction. Researchers used descriptive statistics to analyze TUQ scores across participants, and Pearson correlations between TUQ summary scores and participant demographics. Researchers used a semi-structured interview to examine participants’ experiences of telehealth. Interview questions were based on prior telehealth research (Wallisch et al., 2019), and interviews were recorded and transcribed. Researchers used thematic analyses of transcripts to determine themes depicting participants’ telehealth experiences.

RESULTS: Participants found the telehealth aspect of the intervention program satisfying. On a 1-7 scale with 7 being most satisfied, averages reflect that participants found telehealth useful (6.62), easy to use (6.82), effective (6.4), reliable (5.18), and satisfactory (6.6). Older participant age correlated with perceptions of lower telehealth effectiveness (r = -0.58, p = 0.029), but not overall satisfaction (p = 0.926). Qualitative themes suggested that participants found that telehealth reduced difficult family transitions, created a convenient and neutral intervention space, and fostered contextualized interventions.

CONCLUSION: Parents of CSHCN found the telehealth approach of an occupation-based parent coaching intervention to be satisfying, easy to use, reliable, and effective. Older parents experienced telehealth to be less effective than younger parents, but were still satisfied overall. Parents described the telehealth approach as convenient to access in part due to decreased transitions required for their CSHCN. Parents found telehealth helped practitioners be easily present within their home contexts, maximizing ecologically relevant interventions.

IMPACT STATEMENT: Telehealth offers a portal for OTs to provide contextualized client-centered services for parents of children with special healthcare needs and may afford access to services to support family needs. Findings build evidence for understanding for whom telehealth is well suited which is necessary for determining relevant and fundable service delivery approaches.

References

McPherson, M., Arango, P., Fox, H., Lauver, C., McManus, M., Newacheck, P.W., Perrin, J.M., Shonkoff, J.P., & Strickland, B. (1998). A new definition of children with special health care needs. Journal of Pediatrics, 102(1),138. https://doi.org/10.1542/peds.102.1.137

Parmanto, B., Lewis, A.N., Graham, K.M., Bertolet, M.H. (2016). Development of the Telehealth Usability Questionnaire. International Journal of Telerehabilitation, 8(1), 3-10. https://doi.org/10.5195/ijt.2016.6196

Wallisch, A., Little, L., Pope, E., & Dunn, W. (2019). Parent perspectives of an occupational therapy telehealth intervention. International Journal of Telerehabilitation, 11(1), 15-21. https://doi.org/10.5195/ijt.2019.6274