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Rapid Implementation of Veterans Health Administration Telehealth Creative Arts Therapies: Survey Evaluation of Adoption and Adaptation

Overview
Journal BMC Health Serv Res
Publisher Biomed Central
Specialty Health Services
Date 2023 Jul 19
PMID 37468861
Authors
Kristin M Story
Mindy E Flanagan
Sheri L Robb
Dawn M Bravata
Matthew J Bair
David Otto
Teresa M Damush
Affiliations
Soon will be listed here.
Abstract

Background: Creative arts therapies (CAT) are employed throughout the Veterans Health Administration (VHA) and are predominantly delivered in-person. Though telehealth delivery of CAT was used at several VHA facilities to increase services to rural Veterans, due to guidance from the Center for Disease Control and VHA that temporarily suspended or reduced in-person services, there was a large increase of CAT therapists enterprise-wide who adopted telehealth delivery. The aims of this study were to evaluate adoption and adaptation of CAT telehealth delivery and identify related barriers and facilitators.

Methods: We deployed a survey guided by the Consolidated Framework for Implementation Research and administered it via email to all VHA CAT therapists (N = 120). Descriptive statistics were used to summarize data and responses were compared based on therapists' age, years of experience and CAT discipline. Open survey field responses were summarized, qualitatively coded, and analyzed thematically.

Results: Most therapists (76%) reported adopting telehealth with 74% each delivering > 50 CAT sessions in the prior year. Therapists adapted interventions or created new ones to be delivered through telehealth. Barriers included: technical challenges, control of the virtual space, and building rapport. Facilitators included added equipment, software, and infrastructure. CAT therapists adapted their session preparation, session content, outcome expectations, and equipment. CAT therapists reported being able to reach more patients and improved access to care with telehealth compared to in person visits. Additional benefits were patient therapeutic effects from attending sessions from home, therapist convenience, and clinician growth.

Conclusions: VHA CAT therapists used their inherent creativity to problem solve difficulties and make adaptations for CAT telehealth adoption. Future studies may explore CAT telehealth sustainment and its effectiveness on clinical processes and outcomes.

References
1.
Ferguson J, Jacobs J, Yefimova M, Greene L, Heyworth L, Zulman D . Virtual care expansion in the Veterans Health Administration during the COVID-19 pandemic: clinical services and patient characteristics associated with utilization. J Am Med Inform Assoc. 2020; 28(3):453-462. PMC: 7665538. DOI: 10.1093/jamia/ocaa284. View
2.
Appleton R, Williams J, Vera San Juan N, Needle J, Schlief M, Jordan H . Implementation, Adoption, and Perceptions of Telemental Health During the COVID-19 Pandemic: Systematic Review. J Med Internet Res. 2021; 23(12):e31746. PMC: 8664153. DOI: 10.2196/31746. View
3.
Landes S, Pitcock J, Harned M, Connolly S, Meyers L, Oliver C . Provider perspectives on delivering dialectical behavior therapy via telehealth during COVID-19 in the Department of Veterans Affairs. Psychol Serv. 2021; 19(3):562-572. PMC: 11809750. DOI: 10.1037/ser0000571. View
4.
Kantorova L, Kantor J, Horejsi B, Gilboa A, Svobodova Z, Lipsky M . Adaptation of Music Therapists' Practice to the Outset of the COVID-19 Pandemic-Going Virtual: A Scoping Review. Int J Environ Res Public Health. 2021; 18(10). PMC: 8151825. DOI: 10.3390/ijerph18105138. View
5.
Damschroder L, Reardon C, Widerquist M, Lowery J . The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022; 17(1):75. PMC: 9617234. DOI: 10.1186/s13012-022-01245-0. View