RESUMO
Background: Telehealth has untapped potential to improve health care for underserved communities. However, it remains underutilized, limiting opportunities to improve continuity of care and health care outcomes. This pilot study investigates attitudes and barriers to telehealth at Stony Brook HOME, Renaissance School of Medicine's student-run free-health clinic in Suffolk County, NY. Methods: Surveys (n = 100) were electronically administered bimonthly during clinic waiting room time from May 2022 to August 2023 in both English (40%) and Spanish (60%). Surveys collected information on patient demographics, perceived patient barriers and attitudes to telehealth, and technological comfort levels. Results: Most patients were Hispanic/Latino (68%), female (54%), and 40-60 years old (52%). Spanish speakers often come from high social vulnerability regions. English speakers were more likely to own a smartphone, computer, or tablet than Spanish speakers (p = 0.046). English speakers reported higher levels of technological comfort using a smartphone or tablet (p = 0.0033) and using it for their health care (p = 0.03). Finally, 100% of English speakers reported reliable internet access compared to 66.7% of Spanish speakers. Discussion: These results demonstrate that barriers to telehealth are being disproportionately felt by Spanish speakers, thus necessitating survey-directed interventions to address this disparity.
RESUMO
The COVID-19 pandemic prompted a radical shift in social work practice. Overnight, social work intervention models provided in-person gave way to the utilization of Information and Communication Technologies to facilitate direct practice in virtual environments (e-therapy). Social work's slow acceptance of e-therapy prior to the pandemic resulted in a lack of training for many social work practitioners and MSW student interns, who were required to make rapid transitions to using and operating in online environments. It appears likely that e-therapy will continue after the COVID-19 pandemic subsides, so integrating education about effective e-therapy techniques into social work curricula seems like a logical next step. A social worker's ability to establish the therapeutic alliance, which is at the heart of all helping relationships, will be central to this curricula. Understanding social work students' perceptions of e-therapy and the therapeutic alliance can help shape the development of this new curriculum. Using internal student email, students at two Research I universities were invited to participate in a fully online anonymous survey dealing with attitudes towards e-therapy and the therapeutic alliance. Surveys were conducted in 2018 and April-May 2020. Survey questions were based on the only prior comprehensive study of student attitudes towards e-therapy (Finn in J Soc Work Educ 38(3), 403-419. 10.1080/10437797.2002.10779107, 2002). Study results indicate that students have e-therapy experience, believe that a practitioner can build a good therapeutic alliance, and think that some form of e-therapy will continue after the pandemic. These results confirm that further exploration about the inclusion of e-therapy education and its efficacy in social work curricula requires urgent attention.