Author ORCID Identifier
Date Available
5-10-2025
Year of Publication
2024
Document Type
Doctoral Dissertation
Degree Name
Doctor of Philosophy (PhD)
College
Health Sciences
Department/School/Program
Rehabilitation Sciences
Advisor
Dr. Joneen Lowman
Co-Director of Graduate Studies
Dr. Renee Causey-Upton
Abstract
In the school setting, the telepractice team primarily consists of the clinician and a support person known as a telefacilitator. Though telepractice is an accepted method for delivering school-based speech-language therapy, many barriers to the integration of telepractice as routine care persist. A major barrier is clinicians' acceptance of telehealth. However, there has been limited investigation of factors that influence clinician acceptance. Another barrier is related to support personnel. Telefacilitators have been shown to be an integral part of the telepractice program. Yet there are significant gaps in knowledge regarding the roles and responsibilities, staffing and management, and barriers/facilitators to using these key personnel. Together, these problems make telepractice program implementation more difficult and hinder researchers’ ability to advance telehealth as a field. This dissertation examines three aspects related to telehealth implementation and sustainability. First, we conducted a systematic review and meta-synthesis of factors affecting clinicians’ acceptance of telehealth. Clinicians had positive overall views of telehealth, though most still held reservations about routine use. Telefacilitators were found to be key in managing threats to acceptability. Second, we used survey methods to gather data on the typical profile of school-based telefacilitators. Most telefacilitators were paraprofessionals. Half of the respondents did not receive any training, which negatively affected their confidence and job performance. Third, we described the specific contributions telefacilitators make in school-based telepractice, as well as current practice patterns, using a mixed-methods approach. Current practice patterns were inconsistent due to the absence of guidelines for telefacilitators. However, clinicians described telefacilitators as being “make or break” for telepractice success. School resources and buy-in affected how telefacilitators were implemented. Together, results confirm that telefacilitators play an essential role in building and maintaining a successful telepractice program. Implications, recommendations, and areas for future research are discussed.
Digital Object Identifier (DOI)
https://doi.org/10.13023/etd.2024.115
Funding Information
–Endowed University Professor in Health Sciences Fund, 2022-2023
–Center for Telehealth Education, Research, and Outreach, 2022-2023
–CSD Department, 2022-2023
–Graduate Student Congress, 2022
Recommended Citation
Douglass, Hannah, "Key to Success: A Comprehensive Examination of Support Personnel in School-Based Speech-Language Telepractice" (2024). Theses and Dissertations--Rehabilitation Sciences. 101.
https://uknowledge.uky.edu/rehabsci_etds/101
S2RecruitmentMaterials.pdf (2743 kB)
S2_1RedcapSurvey.pdf (56 kB)
S2_2PaperSurvey.pdf (201 kB)
Included in
Interprofessional Education Commons, Rehabilitation and Therapy Commons, Speech Pathology and Audiology Commons, Telemedicine Commons, Translational Medical Research Commons
