Jesudass Neethi, Ramkumar Vidya, Kumar Shuba, Venkatesh Lakshmi
Department of Audiology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, 600116, India.
SAMARTH, Chennai, Tamil Nadu, 600004, India.
Wellcome Open Res. 2024 May 8;9:239. doi: 10.12688/wellcomeopenres.20977.1. eCollection 2024.
Tele-practice promotes universal and equitable access to quality health services and emerged as an alternative to overcome physical barriers to intervention access in the 90s. There has been a steady increase in adoption since then, and during the COVID-19 pandemic, there was a surge in online modes of healthcare service delivery. Yet, tele-practice adoption and utilization in rural and remote areas are not spontaneous. Therefore, as a first step, prior to the implementation of a comprehensive tele-practice model, a baseline situational analysis was undertaken to assess the needs and readiness of parents of children with disabilities and different cadres of health care providers towards accepting tele-practice services in their settings. This paper describes the process of development of the conceptual framework that guided the baseline needs and readiness assessment (situational analysis).
The Bowen's feasibility framework served as the primary framework to evaluate the feasibility outcomes of the implementation. Therefore, this framework also guided the baseline situational analysis. For specificity of the framework to tele-practice, several telemedicine planning frameworks relevant for low- and middle-income countries were reviewed to identify and map suitable constructs and attributes to the Bowen's constructs. A description of the framework selection process and a review of each of the selected telemedicine frameworks are provided.
The constructs and attributes from this conceptual framework were used to develop the guides for focus group discussions (FGDs) and semi-structured interviews (SSIs). The guides were prepared separately for each stakeholder group.
The developed framework facilitated the assessment of needs and readiness suited to the context and among various stakeholders involved in the proposed implementation of the comprehensive model of tele-practice for childhood communication disorders in rural communities.
远程医疗实践促进了优质医疗服务的普遍和公平获取，并在20世纪90年代成为克服干预获取物理障碍的一种替代方式。从那时起，其采用率稳步上升，在新冠疫情期间，医疗服务的在线提供模式激增。然而，农村和偏远地区对远程医疗实践的采用和利用并非自发的。因此，作为第一步，在实施全面的远程医疗实践模式之前，进行了基线情况分析，以评估残疾儿童家长和不同医疗保健提供者群体在其环境中接受远程医疗实践服务的需求和准备情况。本文描述了指导基线需求和准备情况评估（情况分析）的概念框架的制定过程。
鲍文可行性框架作为评估实施可行性结果的主要框架。因此，该框架也指导了基线情况分析。为使该框架对远程医疗实践具有针对性，对一些与低收入和中等收入国家相关的远程医疗规划框架进行了审查，以确定适合鲍文框架的结构和属性并进行映射。提供了框架选择过程的描述以及对每个选定远程医疗框架的审查。
该概念框架的结构和属性被用于制定焦点小组讨论（FGD）和半结构化访谈（SSI）指南。针对每个利益相关者群体分别编写了指南。
所开发的框架有助于评估适合农村社区儿童沟通障碍综合远程医疗实践模式拟议实施背景及各利益相关者的需求和准备情况。
