Integrating a Video Game Recording into a Qualitative Research Methods Course: Overcoming COVID-19 Barriers to Teaching through Digitally Created Asynchronous Resources.

BACKGROUND: Due to COVID-19, a PhD-level public health qualitative research methods course was moved to an online format. One module originally required students to conduct in-person observations within the community, but the curriculum was adapted using an online video game exercise. OBJECTIVE: This study sought to evaluate students' perceptions of this adaptation and determine if the new pilot format successfully met the module's original learning objectives. METHODS: Recorded footage of a video game session was used for students to observe, take field notes, and compare results. Qualitative methods were used to evaluate student feedback on the curriculum and determine if original learning objectives were met. Data were analyzed using a directed content analysis. RESULTS: Findings demonstrate all learning objectives for this adapted qualitative observational research assignment using an online video game exercise were successfully met, including that students learned how to compare and contrast observational notes of peers and to evaluate how personal bias and environmental factors can affect qualitative data collection. The assignment was also positively received by students. CONCLUSIONS: Results align with constructivist learning theory and other successful COVID-19 implementations. Our study demonstrates that learning objectives of a qualitative observational assignment can be addressed given proper forethought and delivery when adapted to a virtual context using a video game exercise. CLINICALTRIAL: Not applicable.

Whole Health coaching to rural Veterans through telehealth: Advantages, gaps, and opportunities.

Background: The Veterans Health Administration (VHA) is one of the largest providers of telehealth in the United States and continues to lead the way in transforming healthcare services. VHA has been implementing its Whole Health (WH) initiative since 2018, a proactive practice empowering patients to take charge of their health and well-being. A key facilitator of the WH initiative is the WH coach who partners with Veterans to achieve their health-related goals. A gap exists in the literature regarding the understanding of WH coaches' use of telehealth to engage rural-residing Veterans. COVID-19 unexpectedly interrupted in-person VHA delivery of care, including WH coaching which primarily relied on in-person delivery and focused less on telehealth. During the pandemic, WH coaches had to adapt and integrate different modalities to engage their Veteran patients. We examined WH coaches' approaches to extending coaching to rural Veterans via technology, emphasizing the advantages of telehealth, existing gaps in telehealth delivery, and opportunities for telehealth as a coaching modality. Methods: This project was implemented as part of a larger mixed methods evaluation regarding WH coaching for rural Veterans; this manuscript presents the findings from the qualitative data from the larger study. The qualitative dataset is comprised of data collected using three different qualitative methods: four focus groups (n = 11; 3-4 participants per group), in-depth individual interviews (n = 9), and open-ended responses from a national web-based survey (n = 140). Focus group, in-depth interview, and open-ended survey data were collected sequentially and separately analyzed following each wave of data collection. Findings from the three analyses were then collaboratively merged, compared, reorganized, and refined by the evaluation team to create final themes. Results: Three final themes that emerged from the merged data were: (1) Advantages of Telehealth; (2) Telehealth Gaps for Rural Veterans, and (3) Strategies for Bridging Telehealth Gaps. Themes explicate telehealth advantages, gaps, and opportunities for rural Veteran WH coaching. Conclusion: Findings highlight that video telehealth alone is not sufficient for meeting the needs of rural Veterans. Digital technologies hold promise for equalizing health access gaps; however, both human factors and broadband infrastructure constraints continue to require WH coaches to use a mix of modalities in working with rural Veterans. To overcome challenges and bridge gaps, WH coaches should be ready to adopt a blended approach that integrates virtual, in-person, and lower-tech options.

Investigating social support among adolescent and young adult palliative care patients using an online gaming network from the patient perspective

Adolescent and young adult (AYA) patients facing chronic and life-limiting illnesses are a unique population who experience complex health concerns and barriers to accessing psychosocial and palliative care. Research has shown AYAs who receive psychosocial and palliative care can experience numerous benefits from these services;however, there remains a lack of research investigating age-appropriate palliative care programs and interventions targeting the psychosocial needs for AYAs. Streetlight is a peer support palliative care program designed for AYA patients with chronic and life-limiting illnesses. The Streetlight Gaming League (SGL) is an innovative psychosocial intervention aimed at facilitating online social support through an online gaming network. Guided by a phenomenological approach and qualitative methods, the study was developed to investigate AYA patient experiences with an online psychosocial intervention (the SGL) and subsequent experiences of online social support, as well as to add a deeper understanding into how participation style influences online social support among SGL participants. The study utilized questionnaires and semi-structured interviews to examine online social support among SGL patient participants. Findings demonstrate the existence and enactment of online social support among AYA patients using the SGL platform, especially in the form of emotional/esteem, social companionship/belonging, and distraction support. AYA patients reported experiencing positive impacts and psychosocial benefits of online social support through the SGL, such as sense of camaraderie, continuity of relationships, mental health support, and connection during the COVID-19 pandemic. Findings highlight the relevance and meaningfulness of these psychosocial support to AYA patients living with chronic and life-limiting illnesses. They also highlight important implications of participation style. These findings have implications for palliative care programs, as well as future health outcomes research, for the AYA patient population. This study expands the body of knowledge regarding palliative care and psychosocial support interventions for AYAs living with chronic and life-limiting illnesses. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Occupational Therapists' Experiences in Conducting Home Assessments and Modifications: Virtual Versus In-person Home Visits...American Congress of Rehabilitation Medicine (ACRM) 99th Annual Conference, November 8-11, 2022, Chicago, Illinois

To investigate occupational therapists' experiences with home assessments and modifications in VHA, while comparing virtual to in-person home visits. A preliminary qualitative study using semi-structured individual interviews. Department of Veterans Affairs (VA) Home Based Primary Care (HBPC). Purposefully selected occupational therapists implementing home assessments and modifications for rural Veterans (N=3). Not applicable. Semi-structured individual interview via Microsoft Teams. Home visits to conduct home assessments and modifications for rural Veterans were standards of care delivery. However, travel restrictions and social distance during the COVID-19 pandemic required a shift toward virtual care. Our preliminary results show that the VA Video Connect (VVC) application allows occupational therapists to provide instant feedback and training to Veterans when new equipment is installed in the Veteran's home, without the need to drive long-distance. However, the VVC does not allow occupational therapists to measure physical features of the home, such as door threshold height and hallway width. Participants also reported difficulty evaluating Veterans' functioning, such as balance, strength, and gait pattern. Thus, the VVC improves access to the services but requires additional assistance from caregivers compared to in-home assessments. Initial home assessments are recommended to be conducted during home visits, but follow-up visits can be conducted via telehealth depending on Veterans' and caregivers' ability to utilize telehealth devices and perform self-assessments. The study team has no conflicts of interest to report.

Occupational Therapists' Experiences in Conducting Home Assessments and Modifications: Virtual Versus In-person Home Visits

To investigate occupational therapists' experiences with home assessments and modifications in VHA, while comparing virtual to in-person home visits. A preliminary qualitative study using semi-structured individual interviews. Department of Veterans Affairs (VA) Home Based Primary Care (HBPC). Purposefully selected occupational therapists implementing home assessments and modifications for rural Veterans (N=3). Not applicable. Semi-structured individual interview via Microsoft Teams. Home visits to conduct home assessments and modifications for rural Veterans were standards of care delivery. However, travel restrictions and social distance during the COVID-19 pandemic required a shift toward virtual care. Our preliminary results show that the VA Video Connect (VVC) application allows occupational therapists to provide instant feedback and training to Veterans when new equipment is installed in the Veteran's home, without the need to drive long-distance. However, the VVC does not allow occupational therapists to measure physical features of the home, such as door threshold height and hallway width. Participants also reported difficulty evaluating Veterans' functioning, such as balance, strength, and gait pattern. Thus, the VVC improves access to the services but requires additional assistance from caregivers compared to in-home assessments. Initial home assessments are recommended to be conducted during home visits, but follow-up visits can be conducted via telehealth depending on Veterans' and caregivers' ability to utilize telehealth devices and perform self-assessments. The study team has no conflicts of interest to report.

Meeting the Needs of Rural Veterans: A Qualitative Evaluation of Whole Health Coaches' Expanded Services and Support during COVID-19.

The purpose of this qualitative study was to explore perspectives of Whole Health (WH) coaches at the Veterans Health Administration (VHA) on meeting the needs of rural Veterans during the COVID-19 pandemic. The evaluation design employed a qualitative description approach, employing focus groups and in-depth interviews with a convenience sample of WH coaches across the VHA system. Fourteen coaches who work with rural Veterans participated in either one of three focus groups, individual interviews, or both. The focus group data and in-depth interviews were analyzed separately using thematic analysis, and findings were then merged to compare themes across both datasets. Four primary themes were identified: bridging social risk factors for rural Veterans, leveraging technology to stay connected with Veterans at-a-distance, redirecting Veterans to alternate modes of self-care, and maintaining flexibility in coaching role during COVID-19. One overarching theme was also identified following a post-hoc analysis driven by interdisciplinary team discussion: increased concerns for Veteran mental health during COVID-19. Coaches reported using a variety of strategies to respond to the wide-ranging needs of rural Veterans during the pandemic. Implications of findings for future research and practice are discussed.