SUBJECTS AND METHODS
Study design and setting : The study was designed to be an interventional study for Healthcare Workers (HCWs). The study was conducted in Primary Healthcare (PHC) centers in East region of Cairo, Egypt. Data collection was completed in 9 months,
Study population : The study included all the PHC workers who were present at the selected units and agreed to participate and had a role in referring and following up the patients. The selected health care workers needed to fulfill one inclusion criteria that s/he should have spent at least 6 months in PHC units to be familiar with the work nature in such units.
Sampling method: All the present Healthcare workers who were working at the units and met the inclusion criteria and agreed to participate were recruited.
Study’s procedure and data collection: Healthcare Workers questionnaire was designed after Ayatollahi and collaborators after few modifications [9] . It is an adjusted valid self-administered five-point Likert-scale questionnaire. The questionnaire included:
1) Personal information (eleven questions)
2) Healthcare Workers’ knowledge of telemedicine technology (seven questions)
3) Healthcare Workers’ perception of the advantages of telemedicine technology (seven questions)
4) Healthcare Workers’ perception of the disadvantages of telemedicine technology (eight questions)
5) Necessity of deploying telemedicine technology (six questions)
6) Impact of the application’s ease of use (six questions)
7) Importance of the security of telemedicine technology (Six questions).
A total of 109 questionnaires were collected in this phase from healthcare workers who were present and agreed to participate.
The scoring of questionnaire questions was done by five points, as 5 is the highest point and 1 is the lowest. A score was given for each domain then a total score was given for the whole questionnaire.
The health care workers received an Orientation program: The program included one session, which was held after filling the questionnaires. The message delivered during the orientation session covered five points to give better insight on telehealth, the following were the discussed points:
1) Full definition of Telehealth
2) Different technologies in telehealth
3) Application and usage of telehealth
4) Data storage and security
5) Importance of telehealth
The session was a face to face interactive talk for each participant individually. A lot of pictures were presented during the orientation program. The talk was concluded with a sum up to ensure their full comprehension.
A handout with the information mentioned in the session, that was previously prepared including written data and illustrating figures, was given out following the session for reminder and further reading.
In this phase a total of 104 questionnaires were collected, after 2 weeks of the orientation program, giving a response rate = 95.4%. The drop rate is contributed to healthcare workers were on vacation so couldn’t reach them
Statistical analysis : Data was cleaned and processed using SPSS version 23. First, the following descriptive analysis was done: frequency, percentages, mean and standard deviation (SD). Thereafter, a comparison was done using Student t-test for quantitative variables and Fisher exact test for qualitative variables. Level of significance was set at p value equals to or less than 0.05. The adjusted predictive factors for awareness about telehealth were obtained using the logistic regression analysis. The dependent variable was the presence and absence of awareness about telehealth in all HCWs. All variables described previously (age in years, gender, postgraduate study and work experience in months) were considered as possible candidates for the final model. The initial multivariable model construction consisted in the preliminary selection of variables using a manual, purposeful selection method and a relatively large significance level (approximately 0.25). Subsequently, the resulting model was reduced using a likelihood ratio test with a significance level of 0.05. Before accepting a final model, the interactions and confounding variables were evaluated.
Ethical Considerations: Informed consent was taken from every participant. The study protocol was reviewed and approved by the Institutional Review Board in Faculty of Medicine, Ain Shams University.