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首页> 外文期刊>Telemedicine and e-health: the official journal of the American Telemedicine Association >Methodology for Evaluating Models of Telemental Health Delivery Against Population and Healthcare System Needs: Application to Telemental Healthcare for Rural Native Veterans
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Methodology for Evaluating Models of Telemental Health Delivery Against Population and Healthcare System Needs: Application to Telemental Healthcare for Rural Native Veterans

机译：用于评估人口和医疗保健系统需求的Telemental Mealth交付模式的方法：适用于农村原生退伍军人的Telemental Healthcare

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Background: Rural American Indian and Alaska Native (AI/AN) Veterans face exceptional barriers to receiving quality mental healthcare. We aimed to identify models of in-person and telemental health service delivery with promise for adaptation and wide dissemination to rural AI/AN Veterans. Methods: Our method for matching specific populations with models of care includes (1) selecting frameworks that represent the healthcare organization's goals, (2) identifying relevant service delivery models for the target population(s), (3) assessing models against the selected frameworks, and (4) summarizing findings across models. We applied this approach to rural AI/AN Veteran populations. Results: Searches identified 13 current models of service delivery for rural AI/AN Veteran, rural AI/AN, and general rural Veteran populations. These models were assessed against four frameworks-the U.S. Department of Veterans Affairs' Office of Rural Health's Promising Practices, Veterans Health Administration's Guide to Mental Health Services, the Institute for Healthcare Improvement's Triple Aim Framework, and the American Indian Telemental Health Clinic framework. Discussion: The one model used for service delivery for rural AI/AN Veterans increases access and is patient-centered but lacks operational feasibility. Models for rural AI/ANs also increase access and are patient-centered but generally lack effectiveness evaluations. Models for rural Veterans demonstrate beneficial effects on mental health outcomes but do not emphasize cultural adaptations to diverse populations. Conclusions: Our approach to selecting models of service delivery considers the needs of operational partners as well as target populations and emphasizes large-scale implementation alongside effectiveness. Pending further testing, this approach holds promise for wider application.
机译：背景：农村美洲印第安人和阿拉斯加本土（AI / AN）退伍军人面临卓越的障碍，以获得优质心理医疗保健。我们旨在识别与农村AI /退伍军人的适应和广泛传播的承诺，识别私人和Telemental卫生服务的模型。方法：我们将特定群体与护理模型匹配的方法包括（1）选择代表医疗组织目标的框架，（2）识别目标群体的相关服务交付模型，（3）评估针对所选框架的模型（4）跨模型的总结结果。我们将这种方法应用于农村AI /一名资深人口。结果：搜索鉴定了13个农村AI / Rural Ai，Rural Ai / An和General Revicer Veteran Lopulations的现有服务交付模式。这些模型被评估为四个框架 - 美国退伍军人事务部的美国农村卫生局承诺实践办公室，退伍军人卫生管理局的心理健康服务指南，医疗保健改善的三重AIM框架和美国印第安人视线诊所框架。讨论：用于农村AI /退伍军人服务交付的一个模型增加了访问，患者居中，但缺乏操作可行性。农村AI / ANS的模型也增加了访问，患者居中，但通常缺乏有效性评估。农村退伍军人的模型表现出对心理健康结果的有益影响，但不会强调文化适应不同的人口。结论：我们选择服务交付模式的方法考虑了运营伙伴的需求以及目标人群，并强调了效率的大规模实施。待进一步测试，这种方法可以满足更广泛的应用程序。

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