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Abstract Details

Barriers and Facilitators to Telehealth Timed Up and Go (TUG) Assessment in an Underserved Urban Stroke Population
Cerebrovascular Disease and Interventional Neurology
P6 - Poster Session 6 (5:30 PM-6:30 PM)
6-013
Telehealth for assessment & intervention for individuals with neurological conditions has grown since the CoVid-19 pandemic. Our stroke patients are from an underserved urban community with social, personal, and environmental barriers that would impact success of a telehealth program.
To eliminate barriers and facilitate remote assessment of a standardized mobility outcome measure for stroke patients in a telehealth-based study to facilitate physical activity and rehabilitation at home through fitness monitoring and feedback. 
Patients (n= 6 to date) with minor stroke discharged home from acute hospitalization were recruited. Evaluation by the interdisciplinary team determined patient safety for discharge home (6Clicks Mobility Score=46.15(9.12)). A neurologist evaluated the patient through telehealth and information from 1 month monitoring period was reviewed with an infographic guided discussion to enhance self-efficacy. Physical therapy team members executed two TUG trials and determined real-time reliability. The assessors followed a standardized script including a flowsheet with video demonstrations of camera set-up, testing materials and TUG demonstration. Patients provided feedback regarding instruction mode and suggested improvements. The Theoretical Domains Framework (TDF) mapped identified barriers/facilitators, analyzed, and interpreted the results. Intertester reliability for TUG and TUG/physical mobility measure correlation were performed.

The flowsheet, video demonstration, and client feedback eliminated patient barriers in knowledge, environmental context and resources domains. Memory, attention, and decision process barriers were facilitated by flexible patient scheduling and phone call reminders. Professional role/identity barriers were eliminated by optimizing each interprofessional team member’s skill set. Patient selection criteria during hospitalization eliminated the barrier to beliefs about consequences. Beliefs about capability barriers were mitigated by intertester reliability (r2=0.98) during telehealth TUG assessment and correlation with remote monitored average daily step counts (r2=-0.52).

TDF identified facilitators to telehealth TUG assessment in an urban underserved stroke community with resource and environmental constraints and should be utilized to promote equity in health care.

Authors/Disclosures
Imama A. Naqvi, MD (Columbia University)
PRESENTER
Dr. Naqvi has nothing to disclose.
Clare Bassile (Columbia University - Programs in Physical Therapy) No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file