Implementation factors are neglected in research investigating telehealth delivery of allied health services to rural children: A scoping review

Abstract

Introduction Rural children are likely to benefit from the telehealth delivery of multidisciplinary allied healthcare. This study aimed to (a) identify the scope of literature describing the telehealth delivery of allied health services to children living in rural areas and (b) understand the extent to which implementation – that is, specific activities designed to put telehealth into practice – has been investigated in such literature. Methods Systematic scoping review methodology was used to locate studies in which telehealth delivered allied health services to children aged 0–12 who lived rurally (January 1998–January 2018). Two reviewers screened the studies, extracted data and appraised quality with Critical Skills Appraisal Programme checklists. Databases searched were PubMed, MEDLINE, CINAHL, PsycINFO, ERIC and Cochrane Library. Results Data were extracted from 23 papers (two randomised controlled trials, one pseudorandomised controlled trial, one non-randomised experimental trial, two interrupted time series without parallel control groups, 10 case series and seven studies of diagnostic yield). Most were level III ( n = 4) or IV ( n = 17) when classified according to National Health and Medical Research Council guidelines. One study met all Critical Skills Appraisal Programme quality criteria. Allied healthcare interventions were aimed at improving functioning in communication ( n = 10), behaviour and socio-emotional domains ( n = 8) and identifying hearing concerns ( n = 5). Many studies ( n = 12) identified implementation facilitators, largely training and equipment. Only one study referred to an explicit framework for telehealth implementation (user-centred design). Discussion Future research should target occupational therapy, physiotherapy, dietetics and social work, and determine the implementation factors and models likely to create successful telehealth services for this population.