The University of Southampton
University of Southampton Institutional Repository

Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study

Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study
Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study
Background
Telehealth (TH) and telecare (TC) interventions are increasingly valued for supporting self-care in ageing populations; however, evaluation studies often report high rates of non-participation that are not well understood. This paper reports from a qualitative study nested within a large randomised controlled trial in the UK: the Whole System Demonstrator (WSD) project. It explores barriers to participation and adoption of TH and TC from the perspective of people who declined to participate or withdrew from the trial.

Methods
Qualitative semi-structured interviews were conducted with 22 people who declined to participate in the trial following explanations of the intervention (n?=?19), or who withdrew from the intervention arm (n?=?3). Participants were recruited from the four trial groups (with diabetes, chronic obstructive pulmonary disease, heart failure, or social care needs); and all came from the three trial areas (Cornwall, Kent, east London). Observations of home visits where the trial and interventions were first explained were also conducted by shadowing 8 members of health and social care staff visiting 23 people at home. Field notes were made of observational visits and explored alongside interview transcripts to elicit key themes.

Results
Barriers to adoption of TH and TC associated with non-participation and withdrawal from the trial were identified within the following themes: requirements for technical competence and operation of equipment; threats to identity, independence and self-care; expectations and experiences of disruption to services. Respondents held concerns that special skills were needed to operate equipment but these were often based on misunderstandings. Respondents’ views were often explained in terms of potential threats to identity associated with positive ageing and self-reliance, and views that interventions could undermine self-care and coping. Finally, participants were reluctant to risk potentially disruptive changes to existing services that were often highly valued.

Conclusions
These findings regarding perceptions of potential disruption of interventions to identity and services go beyond more common expectations that concerns about privacy and dislike of technology deter uptake. These insights have implications for health and social care staff indicating that more detailed information and time for discussion could be valuable especially on introduction. It seems especially important for potential recipients to have the opportunity to discuss their expectations and such views might usefully feed back into design and implementation.

1472-6963
220
Sanders, Caroline
1121a9ec-e719-489a-9ffd-ae8cb6e49a78
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Bowen, Robert
8a2fb064-d46c-4545-a6e5-ea07095721c5
Bower, Peter
ec553157-a170-4219-8b55-2df813846e44
Hirani, Shashivadan
0dcf33f5-5d93-496c-bbb8-7dc8f79e1712
Cartwright, Martin
4ebf65eb-c627-41f7-8c53-4f544011c91c
Fitzpatrick, Ray
e8a93c39-1f5e-4a7d-bfc2-77cf6dd7435f
Knapp, Martin
39b0d60c-30b1-4b9b-bc7f-13c5bdc7e712
Barlow, James
51253e7e-517c-48b6-98b0-ac82b00a600f
Hendy, Jane
4e0b4603-9184-4967-8168-05bc8f281e6c
Chrysanthaki, Theti
c4ae2ce7-4ad3-470d-930e-42172834022a
Bardsley, Martin
b0971145-6fe5-435f-99cf-5e32608f567d
Newman, Stanton P.
f74e2dc5-69f7-4bcd-911f-0862ccb60356
Sanders, Caroline
1121a9ec-e719-489a-9ffd-ae8cb6e49a78
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Bowen, Robert
8a2fb064-d46c-4545-a6e5-ea07095721c5
Bower, Peter
ec553157-a170-4219-8b55-2df813846e44
Hirani, Shashivadan
0dcf33f5-5d93-496c-bbb8-7dc8f79e1712
Cartwright, Martin
4ebf65eb-c627-41f7-8c53-4f544011c91c
Fitzpatrick, Ray
e8a93c39-1f5e-4a7d-bfc2-77cf6dd7435f
Knapp, Martin
39b0d60c-30b1-4b9b-bc7f-13c5bdc7e712
Barlow, James
51253e7e-517c-48b6-98b0-ac82b00a600f
Hendy, Jane
4e0b4603-9184-4967-8168-05bc8f281e6c
Chrysanthaki, Theti
c4ae2ce7-4ad3-470d-930e-42172834022a
Bardsley, Martin
b0971145-6fe5-435f-99cf-5e32608f567d
Newman, Stanton P.
f74e2dc5-69f7-4bcd-911f-0862ccb60356

Sanders, Caroline, Rogers, Anne, Bowen, Robert, Bower, Peter, Hirani, Shashivadan, Cartwright, Martin, Fitzpatrick, Ray, Knapp, Martin, Barlow, James, Hendy, Jane, Chrysanthaki, Theti, Bardsley, Martin and Newman, Stanton P. (2012) Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study. BMC Health Services Research, 12 (1), 220. (doi:10.1186/1472-6963-12-220). (PMID:3413558)

Record type: Article

Abstract

Background
Telehealth (TH) and telecare (TC) interventions are increasingly valued for supporting self-care in ageing populations; however, evaluation studies often report high rates of non-participation that are not well understood. This paper reports from a qualitative study nested within a large randomised controlled trial in the UK: the Whole System Demonstrator (WSD) project. It explores barriers to participation and adoption of TH and TC from the perspective of people who declined to participate or withdrew from the trial.

Methods
Qualitative semi-structured interviews were conducted with 22 people who declined to participate in the trial following explanations of the intervention (n?=?19), or who withdrew from the intervention arm (n?=?3). Participants were recruited from the four trial groups (with diabetes, chronic obstructive pulmonary disease, heart failure, or social care needs); and all came from the three trial areas (Cornwall, Kent, east London). Observations of home visits where the trial and interventions were first explained were also conducted by shadowing 8 members of health and social care staff visiting 23 people at home. Field notes were made of observational visits and explored alongside interview transcripts to elicit key themes.

Results
Barriers to adoption of TH and TC associated with non-participation and withdrawal from the trial were identified within the following themes: requirements for technical competence and operation of equipment; threats to identity, independence and self-care; expectations and experiences of disruption to services. Respondents held concerns that special skills were needed to operate equipment but these were often based on misunderstandings. Respondents’ views were often explained in terms of potential threats to identity associated with positive ageing and self-reliance, and views that interventions could undermine self-care and coping. Finally, participants were reluctant to risk potentially disruptive changes to existing services that were often highly valued.

Conclusions
These findings regarding perceptions of potential disruption of interventions to identity and services go beyond more common expectations that concerns about privacy and dislike of technology deter uptake. These insights have implications for health and social care staff indicating that more detailed information and time for discussion could be valuable especially on introduction. It seems especially important for potential recipients to have the opportunity to discuss their expectations and such views might usefully feed back into design and implementation.

This record has no associated files available for download.

More information

Published date: 26 July 2012
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 346117
URI: http://eprints.soton.ac.uk/id/eprint/346117
ISSN: 1472-6963
PURE UUID: 827e3b0c-2039-4b4b-9916-9cfd30adaf5a

Catalogue record

Date deposited: 14 Jan 2013 12:15
Last modified: 14 Mar 2024 12:33

Export record

Altmetrics

Contributors

Author: Caroline Sanders
Author: Anne Rogers
Author: Robert Bowen
Author: Peter Bower
Author: Shashivadan Hirani
Author: Martin Cartwright
Author: Ray Fitzpatrick
Author: Martin Knapp
Author: James Barlow
Author: Jane Hendy
Author: Theti Chrysanthaki
Author: Martin Bardsley
Author: Stanton P. Newman

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×