Evaluation of Video Teleconferencing Technology to Provide Chronic Disease Self-Management Access for Rural Veterans
Repository Posting Date2012-01-11T10:51:21Z
Author DetailsJane A. Anderson, PhD; Pamela Willson, RN, PhD, FNP, BC, CNE
(41st Biennial Convention) A study was undertaken to evaluate the use of video teleconference technology (VTEL) for delivery of patient self-management education and preventative care services to reduce stroke risk factors among Veterans receiving primary care services at Community Based Outpatient Clinics (CBOCs) in a five state (VISN 16) service region. Methods: Focus group, survey, and pre/post test methods identified factors associated with feasibility and effectiveness of implementation during this formative evaluation. A sample of (N=30) Veterans with a history of stroke or with multiple stroke risk factors were recruited from CBOCs in VISN 16 in a two-phase study. Phase 1 participants, measures described the effectiveness of VTEL to affect patients' self-management skills, stroke risk knowledge, self-efficacy, and quality of life. Results: Most Veterans were male, age was greater than 50 years, were diagnosed with four or more chronic conditions, and lived alone without the assistance of a caregivers. Their Stroke Scorecard assessments ranged from 12 to 18; health related quality of life was reported as difficult -- they accomplished less physically and emotionally. Ninety-five percent of participants attended all educational sessions and set and accomplished self-management action plans. Access to care was facilitated by implementation VTEL within the community, reducing travel by 86 miles on average. Veteran's agreed or strongly agreed that VTEL program participation was effective in identifying, understanding and taking self-management actions to reduce their to reduce their risk of stroke. Focus group themes and triangulation outcomes will be discussed. Conclusions: The use of VTEL at local CBOCs for group patient self-management education and for specialty clinic visits enhances access to these types of care services for rural Veterans. Participants were very satisfied with Advanced Practice Registered Nurse (APRN) specialty practice of secondary stroke prevention extended to rural settings via VTEL.