Implementation of a Women's Reproductive Behavioral Health Telemedicine Program: a Qualitative Study of Barriers and Facilitators in Obstetric and Pediatric Clinics

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2023 Mar 11

PMID 36906564

Authors

Katherine R Sterba

Emily E Johnson

Edie Douglas

Rubin Aujla

Lisa Boyars

Ryan Kruis

Rebecca Verdin

Rachel Grater

Kathryn King

Dee Ford

Constance Guille

Affiliations

Soon will be listed here.

Abstract

Background: Perinatal Mood and Anxiety Disorders and Substance Use Disorders are common and result in significant morbidities and mortality. Despite evidence-based treatment availability, multiple barriers exist to care delivery. Because telemedicine offers opportunities to overcome these barriers, the objective of this study was to characterize barriers and facilitators to implementing a mental health and substance use disorder telemedicine program in community obstetric and pediatric clinics.

Methods: Interviews and site surveys were completed with practices engaged in a Women's Reproductive Behavioral Health Telemedicine program (N = 6 sites; 18 participants) at the Medical University of South Carolina and telemedicine providers involved in care delivery (N = 4). Using a structured interview guide based on implementation science principles, we assessed program implementation experiences and perceived barriers and facilitators to implementation. A template analysis approach was used to analyze qualitative data within and across groups.

Results: The primary program facilitator was service demand driven by the lack of available maternal mental health and substance use disorder services. Strong commitment to the importance of addressing these health concerns provided a foundation for successful program implementation yet practical challenges such as staffing, space, and technology support were notable barriers. Services were supported by establishing good teamwork within the clinic and with the telemedicine team.

Conclusion: Capitalizing on clinics' commitment to care for women's needs and a high demand for mental health and substance use disorder services while also addressing resource and technology needs will facilitate telemedicine program success. Study results may have implications for potential marketing, onboarding and monitoring implementation strategies to support clinics engaging in telemedicine programs.

Citing Articles

Development of the Dissemination and Implementation Science Collaborative (DISC): Opportunities to enhance implementation science capacity among researchers and practitioners in South Carolina.

Allen C, Sterba K, Oppenheimer S, Hanson R, Coen E, Gimbel R J Clin Transl Sci. 2024; 8(1):e161.

PMID: 39540111 PMC: 11557275. DOI: 10.1017/cts.2024.579.

Improving the Management of Maternal Mental Health with Digital Health Care.

Guille C, Henrich N, Brinson A, Jahnke H Psychiatr Res Clin Pract. 2024; 6(1):23-32.

PMID: 38510485 PMC: 10948940. DOI: 10.1176/appi.prcp.20230035.

Development of an Implementation Science Telehealth Toolkit to Promote Research Capacity in Evaluation of Telehealth Programs.

Johnson E, Kruis R, Verdin R, Wells E, Ford D, Sterba K Telemed Rep. 2023; 4(1):286-291.

PMID: 37817872 PMC: 10561742. DOI: 10.1089/tmr.2023.0039.

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