Evidence-Based Practice Professorial Unit, Gold Coast University Hospital, Southport, Australia.
Institute for Evidence-Based Healthcare, Bond University, Robina, Australia.
Ethn Health. 2023 Jan;28(1):114-135. doi: 10.1080/13557858.2021.2023111. Epub 2022 Jan 4.
To examine the modalities and clinical and non-clinical effectiveness of telehealth services available to people from Indigenous and culturally and linguistically diverse backgrounds (CALD).
A scoping review of peer-reviewed publications (2000-2021) on the effectiveness of telehealth interventions for Indigenous and CALD groups based on searches of Medline, CINAHL, and PsycInfo and manual searches from reference lists of captured literature reviews.
Of the initial 601 articles, 10 met the inclusion criteria (seven of clinical effectiveness and three of non-clinical effectiveness), with participants from the USA, Australia, New Zealand, and Canada, with sample sizes ranging from 19 to 1,665 participants (overall 327 Indigenous and 2,030 CALD patients). Telehealth was delivered via telephone or by videoconference-with or without data uploads-and follow-up ranging from 6 months to 5 years.
The findings suggest that telehealth shows some promise in: diabetes, depression, neuro/cognitive assessment, and health program adherence/service utilisation/cost. However, our confidence in the accuracy of the results is undermined by the mixed quality of designs and outcome measurements, and the high risk of bias derived from not proper random selections and small sample sizes.
The available literature suggests acceptable clinical and non-clinical effectiveness of telehealth against usual care in Indigenous and/or CALD groups but methodological limitations diminish their value in informing practice. Therefore, we consider it is premature to use the findings of these primary studies to draw conclusive recommendations about clinical or other effectiveness of telehealth for the two target groups. Further randomised trials with adequate sampling frames and objective outcome assessments are warranted.
调查可供原住民和文化及语言多样化背景（CALD）人群使用的远程医疗服务的模式以及临床和非临床效果。
对 2000 年至 2021 年期间发表的关于远程医疗干预对原住民和 CALD 群体有效性的同行评审文献进行了范围综述，检索了 Medline、CINAHL 和 PsycInfo，并从已捕获文献综述的参考文献中进行了手动检索。
最初的 601 篇文章中，有 10 篇符合纳入标准（7 篇为临床效果，3 篇为非临床效果），参与者来自美国、澳大利亚、新西兰和加拿大，样本量从 19 到 1665 名参与者不等（总共有 327 名原住民和 2030 名 CALD 患者）。远程医疗通过电话或视频会议进行，可上传或不上传数据，随访时间从 6 个月到 5 年不等。
研究结果表明，远程医疗在以下方面显示出一定的前景：糖尿病、抑郁症、神经/认知评估以及健康计划的依从性/服务利用/成本。然而，由于设计和结果测量的质量参差不齐，以及由于不正确的随机选择和小样本量导致的高偏倚风险，我们对结果的准确性的信心受到了影响。
现有文献表明，远程医疗对原住民和/或 CALD 群体的常规护理具有可接受的临床和非临床效果，但方法学上的局限性降低了其在指导实践方面的价值。因此，我们认为，根据这些初步研究的结果，就远程医疗对这两个目标群体的临床或其他效果做出结论性建议还为时过早。需要进行进一步的随机试验，样本量和客观的结果评估应足够。
