Background: Use of videoconferencing technology for healthcare intervention and support is an area of tremendous potential, especially in regard to application in rural or underserved communities. Potential for cost-savings, time-savings, and increased access to care are the ultimate driving force behind use of this technology, for both providers and recipients of healthcare services. Recently, the Federal Government has initiated rulings to support the increased use of computer technology in underserved areas. Therefore, exploring novel applications of the technology of videoconferencing is timely. Remote lactation consultation may be one such novel application.
Objectives: The primary objective of this pilot study was to describe the maternal experience of lactation consultation by means of videoconferencing, compared with standard face-to-face care, using grounded theory for model development.
Methods: Twelve mothers participated in both a videoconferencing and a face-to-face consultation during one visit to the study site. Using grounded theory methods, responses to an in-depth phone interview occurring 3 days post-consultation were analyzed for major themes and a theoretical model proposed.
Results: Three major themes emerged including maternal characteristics and interaction with technology, accuracy and trust determines acceptability for consultation type and, conditional acceptance of remote consultation use.
Conclusions: Emergent themes were grounded in existing literature, and potential scales were identified to assist with development of a future tool to test the theoretical model. Responses to the videoconferencing experience were positive, but preferred use of the technology was situational.
BellamyGRBolinJNGammLD. Rural healthy people 2010, 2020, and beyond: the need goes on. Fam Community Health. 2011;34:182-188.
2.
DoarnCRPortillaLMSayreMH. NIH Conference on the future of telehealth: essential tools and technologies for clinical research and care: a summary. June 25-26, 2009 Bethesda, Maryland. Telemed J E Health. 2010;16:89-92.
3.
EkelandAGBowesAFlottorpS. Effectiveness of telemedicine: A systematic review of reviews. Int J Med Inform. 2010; 79:736-771.
4.
WadeVAKarnonJElshaugAGHillerJE. A systematic review of economic analyses of telehealth services using real time video communication. BMC Health Serv Res. 2010;10:233.
5.
GrossmanXChaudhuriJFeldman-WinterL. Hospital Education in Lactation Practices (Project HELP): does clinician education affect breastfeeding initiation and exclusivity in the hospital?Birth. 2009;36:54-59.
6.
US Congress. Public Law 111-148. Patient Protection and Affordable Care Act 2010. Washington, DC: US Congress.
7.
SparksPJ. Rural-urban differences in breastfeeding initiation in the United States. J Hum Lact. 2010; 26:118-129.
8.
FlowerKBWilloughbyMCadiganRJPerrinEMRandolphG. Family Life Project I. Understanding breastfeeding initiation and continuation in rural communities: a combined qualitative/quantitative approach. Matern Child Health J. 2008; 12: 402-414.
9.
JamesDCLessenR. Position of the American Dietetic Association: promoting and supporting breastfeeding. J Am Diet Assoc. 2009;109:1926-1942.
10.
Office of the Surgeon General. The Surgeon General’s Call to Action to Support Breastfeeding 2011. Washington, DC: Office of the Surgeon General.
11.
CreswellJW. Qualitative Inquiry and Research Design: Choosing Among Five Traditions. Thousand Oaks, CA. Sage Publications, Inc. 1998.
12.
CharmazK. Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Thousand Oaks, CA. Sage Publications, Inc. 2006.
13.
GuestGBunceAJohnsonL. How many interviews are enough?: an experiment with data saturation and variability. Field Methods. 2006;18:59-82.
14.
HabibiMFNicklasJCHedbergSMagnusonEKavanaghKF. Using Skype for Breastfeeding Consultation: Feasibility Study to Determine Accuracy of Diagnosis and Referral. Abstract presented at the Annual Meeting of the American Public Health Association. Denver, CO. 2010.
VarnfieldMKarunanithiMKSarelaA. Uptake of a technology-assisted home-care cardiac rehabilitation program. Med J Aust. 2011;194:S15-S19.
17.
ShivjiSMetcalfePKhanABratuI. Pediatric surgery telehealth: patient and clinician satisfaction. Pediatr Surg Int. 2011; 27:523-526.
18.
WakefieldBJHolmanJERayA. Effectiveness of home telehealth in comorbid diabetes and hypertension: a randomized, controlled trial. Telemed J E Health. 2011; 17:254-261.
19.
SkinnerCSSiegfriedJCKeglerMCStrecherVJ. The potential of computers in patinent education. Patient Educ Couns. 1993; 22:27-34.
20.
RhoadsM. Face-to-face and computer-mediated communication: what does theory tell us and what have we learned so far?J Plan Lit. 2010; 25:111-122.
21.
DixonRFStahlJE. Virtual visits in a general medicine practice: a pilot study. Telemed J E Health. 2008; 14:525-530.
22.
BrownHGPooleMSRodgersTL. Interpersonal traits, complementarity, and trust in virtual collaboration. J Manage Inform Syst. 2004; 20:115-137.
23.
DavisFDBagozziRPWarshawPR. User acceptance of computer technology: a comparison of 2 theorietical models. Manage Sci. 1989; 35:982-1003.
24.
HoldenRJKarshBT. The technology acceptance model: its past and its future in health care. J Biomed Inform. 2010; 43:159-172.
25.
van DeursenAvan DijkJ. Internet skills performance tests: are people ready for eHealth?J Med Internet Res. 2011;13.
26.
BeldadAde JongMSteehouderM. How shall I trust the faceless and the intangible? A literature review on the antecedents of online trust. Comput Hum Behav. 2010;26:857-869.
27.
DimitriadisSKyrezisN. Linking Trust to use intention for technology-enabled bank channels: the role of trusting intentions. Psychol Mark. 2010; 27:799-820.
28.
OrCKKarshBTSevertsonDJBurkeLJBrownRLBrennanPF. Factors affecting home care patients’ acceptance of a web-based interactive self-management technology. J Am Med Inf Assoc. 2011;18:51-59.
