Browsing by Author "Hunter I"

Now showing 1 - 6 of 6
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    Enabling Rural Telehealth for Older Adults in Underserved Rural Communities: Focus Group Study
    (JMIR Publications, 2022-11-04) Hunter I; Lockhart C; Rao V; Tootell B; Wong S
    Background: Telehealth is often suggested to improve access to health care and has had significant publicity worldwide during the COVID-19 pandemic. However, limited studies have examined the telehealth needs of underserved populations such as rural communities. Objective: This study aims to investigate enablers for telehealth use in underserved rural populations to improve access to health care for rural older adults. Methods: In total, 7 focus group discussions and 13 individual interviews were held across 4 diverse underserved rural communities. A total of 98 adults aged ≥55 years participated. The participants were asked whether they had used telehealth, how they saw their community’s health service needs evolving, how telehealth might help provide these services, and how they perceived barriers to and enablers of telehealth for older adults in rural communities. Focus group transcripts were thematically analyzed. Results: The term telehealth was not initially understood by many participants and required an explanation. Those who had used telehealth reported positive experiences (time and cost savings) and were likely to use telehealth again. A total of 2 main themes were identified through an equity lens. The first theme was trust, with 3 subthemes—trust in the telehealth technology, trust in the user (consumer and health provider), and trust in the health system. Having access to reliable and affordable internet connectivity and digital devices was a key enabler for telehealth use. Most rural areas had intermittent and unreliable internet connectivity. Another key enabler is easy access to user support. Trust in the health system focused on waiting times, lack of and/or delayed communication and coordination, and cost. The second theme was choice, with 3 subthemes—health service access, consultation type, and telehealth deployment. Access to health services through telehealth needs to be culturally appropriate and enable access to currently limited or absent services such as mental health and specialist services. Accessing specialist care through telehealth was extremely popular, although some participants preferred to be seen in person. A major enabler for telehealth was telehealth deployment by a fixed community hub or on a mobile bus, with support available, particularly when combined with non–health-related services such as internet banking. Conclusions: Overall, participants were keen on the idea of telehealth. Several barriers and enablers were identified, particularly trust and choice. The term telehealth is not well understood. The unreliable and expensive connectivity options available to rural communities have limited telehealth experience to phone or patient portal use for those with connectivity. Having the opportunity to try telehealth, particularly by using video, would increase the understanding and acceptance of telehealth. This study highlights that local rural communities need to be involved in designing telehealth services within their communities.
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    Reality vs expectations: An exploratory study of New Zealand nurses' perceptions of HR measures
    (13/03/2018) Tretiakov A; Hunter I; Tootell B; Wilson S; Toulson P
    When nurses believe that human resources (HR) measures used to record data describing their work are inappropriate, it may result in low engagement in the measurement process and in higher on-the-job stress, and it may be indicative of problems in the HR system. The purpose of the present study is to explore nurses' views on which HR measures are most appropriate for use in the healthcare sector and their perceptions of the current practice at their organisations. A cross-sectional survey of registered nurses in New Zealand was conducted, resulting in N=916. The respondents rated commonly used HR measures for importance and indicated whether they are used in their organisations. The data were analysed by using graphical representations of descriptive statistics to identify patterns in the relationship between perceived importance and perceived use of HR measures. Patient satisfaction and nurses' competencies measures were seen as both highly important and in use. However, a group of measures related to nurses' job satisfaction and empowerment stood out as, from nurses' perspectives, highly important but relatively unused. The results suggest that in healthcare organisations in New Zealand there is a divergence between nurses' ideas about the best HR measurement practice and their perceptions of the current practice. We argue that to address the underlying causes of the divergence and to mitigate its negative effects, healthcare organisations should involve nurses in making decisions regarding the use of HR measures.
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    Survey protocol for exploring video and phone use in Aotearoa New Zealand general practice: considerations for future telehealth
    (BMJ Publishing Group Ltd and BCS, the Chartered Institute for IT, 2021-03-22) Day K; Hunter I; Rao V; Russell G; Roskvist R; Moir F; Gill E; van der Werf B
    Introduction Telehealth became the most practical option for general practice consultations in Aotearoa New Zealand (NZ) as a result of the national lockdowns in response to the COVID-19 pandemic. What is the consumer experience of access to telehealth and how do consumers and providers perceive this mode of care delivery going forward? Methods and analysis A national survey of general practice consumers and providers who used telehealth services since the national lockdowns in 2020 will be distributed. It is based on the Unified Theory of Acceptance and Use of Technology framework of technology acceptance and the access to care framework. The data will be statistically analysed to create a foundation for in-depth research on the use of telehealth services in NZ general practice services, with a specific focus on consumer experiences and health outcomes. Ethics and dissemination Ethics approval was granted by the Auckland Health Research Ethics Committee on 13/11/2020, reference AH2539. The survey will be disseminated online.
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    Telehealth at Home: Co-Designing a Smart Home Telehealth System
    (IOP Press BV, 2021-04-19) Hunter I; Elers P; Lockhart C; Guesgen H; Whiddett D; Singh A; Maeder AJ; Higa C; van den Berg MEL; Gough C
    Increasing life expectancy and rates of chronic conditions place increasing demands on aged care health and support services. One response preferred by older adults and seen as cost effective is aging in place, whereby older people remain in their own homes and avoid aged residential care. For this to take place, it is crucial that older people maintain effective relationships with support networks and that older adults and these networks have adequate information to support patient centred health and wellness care at home. This study explored how smart home telehealth, a form of telehealth where health care is provided at a distance using smart home digital technology (sensors), could assist older people to age in place and enhance their health and wellbeing. It was a two-phase project, preceded by a workshop with experts:1) 41 interviews with older adults and their informal support networks, seven focus groups with 44 health providers working with older adults, which informed 2) a pilot implementation of a co-designed telehealth system, addressing key barriers identified in Phase 1. The system used low cost, easily accessible, and commercially available sensors, transferring information via email and/or text messaging. It was successfully piloted with five older adults and twelve of their respective support networks for six months, who reported an increased feeling of security and improved interpersonal communication. The findings indicate that smart home telehealth could assist aging in place, and the study provides insights into successful co-design of smart home telehealth services at scale that could be implemented and deployed in contexts wider than aged care.
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    User Experiences of the NZ COVID Tracer App in New School of ManagementZealand: Thematic Analysis of Interviews
    (JMIR Publications, 2021-09-08) Tretiakov A; Hunter I
    BACKGROUND: For mobile app-based COVID-19 contact tracing to be fully effective, a large majority of the population needs to be using the app on an ongoing basis. However, there is a paucity of studies of users, as opposed to potential adopters, of mobile contact tracing apps and of their experiences. New Zealand, a high-income country with western political culture, was successful in managing the COVID-19 pandemic, and its experience is valuable for informing policy responses in similar contexts. OBJECTIVE: This study asks the following research questions: (1) How do users experience the app in their everyday contexts? and (2) What drives the use of the app? METHODS: Residents of New Zealand's Auckland region, which encompasses the country's largest city, were approached via Facebook, and 34 NZ COVID Tracer app users were interviewed. Interview transcripts were analyzed using thematic analysis. RESULTS: Interviews ranged in duration from 15 to 50 minutes. Participants ranged in age from those in their late teens to those in their early sixties. Even though about half of the participants identified as White New Zealanders of European origin, different ethnicities were represented, including New Zealanders of South Pacific, Indian, Middle Eastern, South American, and Southeast Asian descent. Out of 34 participants, 2 (6%) identified as Māori (Indigenous New Zealanders). A broad range of careers were represented, from top-middle management to health support work and charity work. Likewise, educational backgrounds ranged broadly, from high school completion to master's degrees. Out of 34 participants, 2 (6%) were unemployed, having recently lost their jobs because of the pandemic. The thematic analysis resulted in five major themes: perceived benefits, patterns of use, privacy, social influence, and need for collective action. Benefits of using the app to society in general were more salient to the participants than immediate health benefits to the individual. Use, however, depended on the alert level and tended to decline for many participants at low alert levels. Privacy considerations played a small role in shaping adoption and use, even though the participants were highly aware of privacy discourse around the app. Participants were aware of the need for high levels of adoption and use of the app to control the pandemic. Attempts to encourage others to use the app were common, although not always successful. CONCLUSIONS: Appeals to civic responsibility are likely to drive the use of a mobile contact tracing app under the conditions of high threat. Under the likely scenario of COVID-19 remaining endemic and requiring ongoing vigilance over the long term, other mechanisms promoting the use of mobile contact tracing apps may be needed, such as offering incentives. As privacy is not an important concern for many users, flexible privacy settings in mobile contact tracing apps allowing users to set their optimal levels of privacy may be appropriate.
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    Using ‘Health’ to Promote Older Adults’ Digital Health Literacy
    (European Society of Medicine, 2024-07-01) Lockhart C; Hunter I
    Aim: This project explored requirements for digital learning to support digital health literacy of older adults within a rural region. Method: A qualitative study with purposeful sampling and thematic analysis of data. Interviews were held with ten digital educators and seven older adults (four with low vision) living and/or working in rural New Zealand. Results: All participants recognised the importance of trust and having the right people to provide support and foster positive engagement with digital technologies. The digital educators recognised a missed opportunity to engage older adults using health as a topic for digital learning. Conclusion: A positive experience with learning to use digital technologies is necessary to facilitate digital health literacy for older adults. Digital educators want access to reputable resources to promote health websites; many don’t know these exist. A wide range of digital literacy learning services exist which need to be better promoted in hard copy and online. The authors recommend building on older adults’ existing relationships, engaging with community groups, providing pop-up sessions, and running events to increase digital technological knowledge and engage with health information online. The key is utilising the right people to support the older adult with opportunities for digital skills uptake