Factors influencing mental health providers’ intention to use telepsychotherapy in First Nations communities

Abstract

Telemental health is the use of information and communications technologies and broadband networks to deliver mental health services and support wellness. Although numerous studies have demonstrated the efficiency and utility of telemental health, certain barriers may impede its implementation, including the attitudes of mental health service providers. The current study draws on the technology acceptance model (TAM) to understand the role of mental health service providers' attitudes and perceptions of telemental health (psychotherapy delivered via videoconferencing) on their intention to use this technology with their patients. A sample of 205 broadly defined mental health service providers working on 32 First Nations reserves in the province of Quebec completed the questionnaire adapted to assess TAM for telepsychotherapy. Confirmatory factor analysis and structural equation modeling provided evidence for the factor validity and reliability of the TAM in this sample. The key predictor of the intention to use telepsychotherapy was not mental health providers' attitude toward telepsychotherapy, nor how much they expected this service to be complicated to use, but essentially how useful they expect it to be for their First Nations patients. If telemental health via videoconferencing is to be implemented in First Nations communities, it is essential to thoroughly demonstrate its utility to mental health providers. Perceived usefulness will have a positive impact on attitudes toward this technology, and perceived ease of use will positively influence perceived usefulness. Cultural issues specific to the populations receiving telemental health services may be more efficiently addressed from the angle of perceived usefulness.

Psychometric properties of implementation measures for public health and community settings and mapping of constructs against the Consolidated Framework for Implementation Research: a systematic review

“…The majority of measures were developed in the USA ( n  = 28), with Canada and Australia also having developed three or more measures each. Sixteen measures were developed for use in school settings [38–52], six for use in universities or colleges [53–60], three for use in pharmacies [61–63], two for use in police or correctional facilities [64, 65], two for use in nursing homes [66, 67], six for use with whole communities or in multiple settings [68–75], and sixteen measures were developed for use in workplace settings or other organisations (e.g. utility companies, IT service providers, human services) [76–92].…”

“…The internal structure of 45 instruments was determined via EFA (11 of these also used CFA [42, 49, 52, 54, 55, 59, 65, 67, 77, 78, 82, 91–93]), and six studies used CFA alone [39, 40, 68, 72, 75, 83, 94] (Additional file 3). For studies which conducted EFA, 46 % reported that >50 % of the variance was explained by the final factor model.…”

“…The internal consistency of both the total scale and the domains was reported for four measures [40, 61, 66, 76], the internal consistency of the total scale only was reported for five measures (all alpha’s >0.70) [47, 49, 51, 75, 83], and the internal consistency for the scale domains only was reported for the remaining 41 measures. Twenty measures achieved a Cronbach’s alpha of >0.70 for all of their domains [38, 40, 41, 48, 50–52, 54, 59, 60, 63, 76, 79, 81, 84, 85, 87, 89, 90, 95, 96], indicating that more than 50 % of measures did not meet the acceptable threshold for at least one domain.…”

“…Seventeen measures reported acceptability and feasibility, with five studies reporting the time that it took to complete the measure (range 10–70 min; M =  34.6 min) [39, 64, 73, 81, 90] and six studies reporting the proportion of missing items observed following the measure administration (range 1.5–5 %) [52, 59, 63, 67, 75, 84] (Additional file 5). Seven studies examined responsiveness in relation to effect sizes [38, 47, 67, 69, 75, 93, 97], and all but one reported an effect size above the threshold criterion of 0.5 [67], indicating that these measures are capable of detecting moderate size change (Additional file 5).…”

“…Seven studies examined responsiveness in relation to effect sizes [38, 47, 67, 69, 75, 93, 97], and all but one reported an effect size above the threshold criterion of 0.5 [67], indicating that these measures are capable of detecting moderate size change (Additional file 5). No studies reported floor or ceiling effects.…”