<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.0 20040830//EN" "http://dtd.nlm.nih.gov/publishing/2.0/journalpublishing.dtd">
<article article-type="abstract" dtd-version="2.0" xmlns:xlink="http://www.w3.org/1999/xlink">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">IPROC</journal-id>
      <journal-id journal-id-type="nlm-ta">iproc</journal-id>
      <journal-title>Iproceedings</journal-title>
      <issn pub-type="epub">2369-6893</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="publisher-id">v8i1e39342</article-id>
      <article-id pub-id-type="pmid"/>
      <article-id pub-id-type="doi">10.2196/39342</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Abstract</subject>
        </subj-group>
        <subj-group subj-group-type="article-type">
          <subject>Abstract</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Experiences of Older Veterans Who Participated in a Multicomponent Telehealth Program: Qualitative Program Evaluation</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="editor">
          <name>
            <surname>Pagoto</surname>
            <given-names>Sherry</given-names>
          </name>
        </contrib>
      </contrib-group>
      <contrib-group>
        <contrib id="contrib1" contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Rauzi</surname>
            <given-names>Michelle R</given-names>
          </name>
          <degrees>DPT, ATC</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <address>
            <institution>Physical Therapy Program</institution>
            <institution>Department of Physical Medicine and Rehabilitation</institution>
            <institution>University of Colorado</institution>
            <addr-line>Mail Stop C244, Room 3107</addr-line>
            <addr-line>13121 E 17th Ave</addr-line>
            <addr-line>Aurora, CO, 80045</addr-line>
            <country>United States</country>
            <phone>1 3037249590</phone>
            <email>michelle.rauzi@cuanschutz.edu</email>
          </address>
          <ext-link ext-link-type="orcid">https://orcid.org/0000-0002-8234-5015</ext-link>
        </contrib>
        <contrib id="contrib2" contrib-type="author">
          <name name-style="western">
            <surname>Mealer</surname>
            <given-names>Meredith L</given-names>
          </name>
          <degrees>RN, PMHNP, PhD</degrees>
          <xref rid="aff2" ref-type="aff">2</xref>
          <xref rid="aff3" ref-type="aff">3</xref>
        </contrib>
        <contrib id="contrib3" contrib-type="author">
          <name name-style="western">
            <surname>Nearing</surname>
            <given-names>Kathryn A</given-names>
          </name>
          <degrees>PhD, MA</degrees>
          <xref rid="aff4" ref-type="aff">4</xref>
          <xref rid="aff5" ref-type="aff">5</xref>
        </contrib>
        <contrib id="contrib4" contrib-type="author">
          <name name-style="western">
            <surname>Magnan</surname>
            <given-names>Elizabeth K</given-names>
          </name>
          <degrees>BA</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
        </contrib>
        <contrib id="contrib5" contrib-type="author">
          <name name-style="western">
            <surname>Abbate</surname>
            <given-names>Lauren M</given-names>
          </name>
          <degrees>MD, PhD</degrees>
          <xref rid="aff5" ref-type="aff">5</xref>
        </contrib>
        <contrib id="contrib6" contrib-type="author">
          <name name-style="western">
            <surname>Stevens-Lapsley</surname>
            <given-names>Jennifer E</given-names>
          </name>
          <degrees>PT, PhD, FAPTA</degrees>
          <xref rid="aff1" ref-type="aff">1</xref>
          <xref rid="aff5" ref-type="aff">5</xref>
        </contrib>
      </contrib-group>
      <aff id="aff1">
        <label>1</label>
        <institution>Physical Therapy Program</institution>
        <institution>Department of Physical Medicine and Rehabilitation</institution>
        <institution>University of Colorado</institution>
        <addr-line>Aurora, CO</addr-line>
        <country>United States</country>
      </aff>
      <aff id="aff2">
        <label>2</label>
        <institution>Department of Physical Medicine and Rehabilitation</institution>
        <institution>School of Medicine</institution>
        <institution>University of Colorado</institution>
        <addr-line>Aurora, CO</addr-line>
        <country>United States</country>
      </aff>
      <aff id="aff3">
        <label>3</label>
        <institution>Mental Illness Research Education and Clinical Center</institution>
        <institution>VA Eastern Colorado Healthcare System</institution>
        <addr-line>Aurora, CO</addr-line>
        <country>United States</country>
      </aff>
      <aff id="aff4">
        <label>4</label>
        <institution>Division of Geriatric Medicine</institution>
        <institution>School of Medicine</institution>
        <institution>University of Colorado</institution>
        <addr-line>Aurora, CO</addr-line>
        <country>United States</country>
      </aff>
      <aff id="aff5">
        <label>5</label>
        <institution>VA Eastern Colorado Geriatric Research Education and Clinical Center (GRECC)</institution>
        <addr-line>Aurora, CO</addr-line>
        <country>United States</country>
      </aff>
      <author-notes>
        <corresp>Corresponding Author: Michelle R Rauzi <email>michelle.rauzi@cuanschutz.edu</email></corresp>
      </author-notes>
      <pub-date pub-type="collection">
        <season>Jan-Dec</season>
        <year>2022</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>6</day>
        <month>7</month>
        <year>2022</year>
      </pub-date>
      <volume>8</volume>
      <issue>1</issue>
      <elocation-id>e39342</elocation-id>
      <history>
        <date date-type="received">
          <day>6</day>
          <month>5</month>
          <year>2022</year>
        </date>
        <date date-type="accepted">
          <day>15</day>
          <month>6</month>
          <year>2022</year>
        </date>
      </history>
      <copyright-statement>©Michelle R Rauzi, Meredith L Mealer, Kathryn A Nearing, Elizabeth K Magnan, Lauren M Abbate, Jennifer E Stevens-Lapsley. Originally published in Iproceedings (https://www.iproc.org), 06.07.2022.</copyright-statement>
      <copyright-year>2022</copyright-year>
      <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
        <p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on https://www.iproc.org/, as well as this copyright and license information must be included.</p>
      </license>
      <self-uri xlink:href="https://www.iproc.org/2022/1/e39342" xlink:type="simple"/>
      <abstract>
        <sec sec-type="background">
          <title>Background</title>
          <p>Older veterans have greater medical complexity, lower physical function, and less daily physical activity compared to age-matched civilians. Telehealth programs offer promising approaches to address these complex needs and improve access for diverse patient populations.</p>
        </sec>
        <sec sec-type="objective">
          <title>Objective</title>
          <p>The purpose of this program evaluation was to understand veterans’ experiences of the telehealth program’s quality, feasibility, safety, and effectiveness.</p>
        </sec>
        <sec sec-type="methods">
          <title>Methods</title>
          <p>Interviews were conducted by a provider and external evaluator who had expertise in qualitative methods; veterans were interviewed following completion of the 12-week program. Questions were designed to explore both positive and negative experiences of the program and its 4 components, which were physical therapy, biobehavioral intervention (coaching), social support, and technology. Interviews were audio recorded and transcribed verbatim. Team-based–directed content analysis, using deductive and inductive thematic analysis, was conducted to identify themes; analysis was supported by structured debriefs following each interview and using Dedoose software.</p>
        </sec>
        <sec sec-type="results">
          <title>Results</title>
          <p>Twenty-one veterans enrolled in the program (n=14 completed). All 14 completers and 1 withdrawer completed the interviews (mean 60.4, SD 8.2 minutes); interviewees were mostly male (73.3%), White (60.0%), and non-Hispanic (86.7%). The following 6 domains were identified (subthemes to follow): (1) technology, (2) social network, (3) therapeutic relationship, (4) access, (5) feasibility, and (6) patient characteristics. Technology—although veterans noted varying levels of technology competency and satisfaction, most felt encouraged and held accountable to being active by the technology. Social Network—this domain highlighted themes surrounding veterans’ social support both within and outside of the program, which reportedly enhanced motivation and commitment to regular exercise. Therapeutic Relationship—interviewees shared specific ways that providers significantly contributed to their overall experience and their progress. Access—older veterans described the pros and cons of telehealth and noted the program made it possible to begin physical therapy sooner than they would have in person. Telehealth also made it easier for them to fit physical therapy sessions into their workdays, and for some, it provided a solution to overcome mental and physical health issues precluding in-person care. Feasibility—themes of preparedness, fit with daily routine, manageability, and outcomes of the program emerged. Patient Characteristics—motivation, self-efficacy, attitudes and beliefs, and expectations influenced the perceived benefits, overall experience, and therapeutic relationship experienced by the veterans. Finally, many veterans provided constructive feedback to improve the program (eg, organizing group sessions based on functional ability and further integrating technology and wearable data).</p>
        </sec>
        <sec sec-type="conclusions">
          <title>Conclusions</title>
          <p>This program evaluation identified impactful aspects of the telehealth program and mechanisms of how those aspects contributed to participants’ satisfaction and outcomes. Veterans offered suggestions to inform ongoing quality and operational improvements, with implications for staffing, training, and patient engagement. Qualitative feedback from the program evaluation identified additional questions to explore through rigorous qualitative research.</p>
        </sec>
        <sec>
          <title>Conflicts of Interest</title>
          <p>None declared.</p>
        </sec>
      </abstract>
      <kwd-group>
        <kwd>telehealth</kwd>
        <kwd>older adult</kwd>
        <kwd>veteran</kwd>
        <kwd>physical therapy</kwd>
      </kwd-group>
    </article-meta>
  </front>
</article>
