Designing a multifaceted telehealth intervention for a rural population using a model for developing complex...

Area of Science:

• Nursing
• Health Services Research
• Telehealth

Background:

• Telehealth interventions are evidence-based for cost-effective remote care and education.
• Telehealth adoption is limited in rural areas due to complex program design and implementation challenges.
• A theory-based approach is needed to optimize telehealth for rural populations with multiple chronic conditions.

Purpose of the Study:

• To explore the application of the Model for Developing Complex Interventions in Nursing.
• To design a pilot telehealth intervention for rural individuals with multiple chronic conditions.
• To address barriers in telehealth program development and implementation.

Main Methods:

• Convened a design team with state representatives, telehealth experts, and patient advocates.
• Utilized major model constructs: problem identification, population definition, objective setting, measurement, theory selection, and intervention protocol development.
• Conducted literature reviews for evidence-based practice alignment and considered scope of practice.

Main Results:

• Developed and gained acceptance for an adaptive pilot telehealth intervention over six months.
• Targeted home and community-based Medicaid Waiver Program participants in rural areas.
• Selected asynchronous (remote monitoring) and synchronous (nursing assessment, care coordination) telehealth methods to manage multiple comorbidities and prevent re-institutionalization. Included an economic evaluation plan.

Conclusions:

• The Model for Developing Complex Interventions in Nursing provided a structured process for designing a multifaceted telehealth intervention.
• The intervention aims to minimize re-institutionalization in patients with multiple chronic conditions.
• This structured approach can facilitate efficient telehealth intervention development in resource-constrained settings.