Browsing by Author "Perry, Kathleen R"

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    How can equitable video visit access be delivered in primary care? A qualitative study among rural primary care teams and patients
    (BMJ Open, 2022-08) Goldstein, Karen M; Perry, Kathleen R; Lewinski, Allison; Walsh, Conor; Shepherd-Banigan, Megan E; Bosworth, Hayden B; Weidenbacher, Hollis; Blalock, Dan V; Zullig, Leah L
    ObjectiveThe COVID-19 pandemic sparked exponential growth in video visit use in primary care. The rapid shift to virtual from in-person care exacerbated digital access disparities across racial groups and rural populations. Moving forward, it is critical to understand when and how to incorporate video visits equitably into primary care. We sought to develop a novel clinical algorithm to guide primary care clinics on how and when to employ video visits as part of care delivery.DesignQualitative data collection: one team member conducted all patient semistructured interviews and led all focus groups with four other team members taking notes during groups.Setting3 rural primary care clinics in the USA.Participants24 black veterans living in rural areas and three primary care teams caring for black veterans living in rural areas.Primary and secondary outcome measuresFindings from semistructured interviews with patients and focus groups with primary care teams.ResultsKey issues around appropriate use of video visits for clinical teams included having adequate technical support, encouraging engagement during video visits and using video visits for appropriate clinical situations. Patients reported challenges with broadband access, inadequate equipment, concerns about the quality of video care, the importance of visit modality choice, and preferences for in-person care experience over virtual care. We developed an algorithm that requires input from both patients and their care team to assess fit for each clinical encounter.ConclusionsInformed matching of patients and clinical situations to the right visit modality, along with individual patient technology support could reduce virtual access disparities.
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    Team-Based Qualitative Rapid Analysis: Approach and Considerations for Conducting Developmental Formative Evaluation for Intervention Design.
    (Qualitative health research, 2023-07) Schexnayder, Julie; Perry, Kathleen R; Sheahan, Kate; Majette Elliott, Nadya; Subramaniam, Soumya; Strawbridge, Elizabeth; Webel, Allison R; Bosworth, Hayden B; Gierisch, Jennifer M
    Qualitative rapid analysis is one of many rapid research approaches that offer a solution to the problem of time constrained health services evaluations and avoids sacrificing the richness of qualitative data that is needed for intervention design. We describe modifications to an established team-based, rapid analysis approach that we used to rapidly collect and analyze semi-structured interview data for a developmental formative evaluation of a cardiovascular disease prevention intervention. Over 18 weeks, we conducted and analyzed 35 semi-structured interviews that were conducted with patients and health care providers in the Veterans Health Administration to identify targets for adapting the intervention in preparation for a clinical trial. We identified 12 key themes describing actionable targets for intervention modification. We highlight important methodological decisions that allowed us to maintain rigor when using qualitative rapid analysis for intervention adaptation and we provide practical guidance on the resources needed to execute similar qualitative studies. We additionally reflect on the benefits and challenges of the described approach when working within a remote research team environment.ClinicalTrials.gov: NCT04545489.