Factors influencing mental health providers’ intention to use telepsychotherapy in First Nations communities

Telemental health is the use of information and communications technologies and broadband networks to deliver mental health services and support wellness. Although numerous studies have demonstrated the efficiency and utility of telemental health, certain barriers may impede its implementation, including the attitudes of mental health service providers. The current study draws on the technology acceptance model (TAM) to understand the role of mental health service providers’ attitudes and perceptions of telemental health (psychotherapy delivered via videoconferencing) on their intention to use this technology with their patients. A sample of 205 broadly defined mental health service providers working on 32 First Nations reserves in the province of Quebec completed the questionnaire adapted to assess TAM for telepsychotherapy. Confirmatory factor analysis and structural equation modeling provided evidence for the factor validity and reliability of the TAM in this sample. The key predictor of the intention to use telepsychotherapy was not mental health providers’ attitude toward telepsychotherapy, nor how much they expected this service to be complicated to use, but essentially how useful they expect it to be for their First Nations patients. If telemental health via videoconferencing is to be implemented in First Nations communities, it is essential to thoroughly demonstrate its utility to mental health providers. Perceived usefulness will have a positive impact on attitudes toward this technology, and perceived ease of use will positively influence perceived usefulness. Cultural issues specific to the populations receiving telemental health services may be more efficiently addressed from the angle of perceived usefulness.

[1]  H White,et al.  A prospective satisfaction study and cost analysis of a pilot child telepsychiatry service in Newfoundland , 2001, Journal of telemedicine and telecare.

[2]  D. A. Kenny,et al.  Reflections on Mediation , 2008 .

[3]  James M. Clark,et al.  Practising Psychology in Rural Settings: Issues and Guidelines* , 2003 .

[4]  André Beauducel,et al.  On the Performance of Maximum Likelihood Versus Means and Variance Adjusted Weighted Least Squares Estimation in CFA , 2006 .

[5]  Fred D. Davis User Acceptance of Information Technology: System Characteristics, User Perceptions and Behavioral Impacts , 1993, Int. J. Man Mach. Stud..

[6]  Deanne C. Simms,et al.  To use or not to use: Clinicians' perceptions of telemental health. , 2011 .

[7]  Gordon W. Cheung,et al.  Estimating and Comparing Specific Mediation Effects in Complex Latent Variable Models , 2012 .

[8]  S. West,et al.  A comparison of methods to test mediation and other intervening variable effects. , 2002, Psychological methods.

[9]  Patrice Renaud,et al.  Delivering cognitive-behavior therapy for panic disorder with agoraphobia in videoconference. , 2004, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[10]  Stéphane Bouchard,et al.  Cognitive Behavior Therapy for Panic Disorder with Agoraphobia in Videoconference: Preliminary Results , 2000, Cyberpsychology Behav. Soc. Netw..

[11]  Younghwa Lee,et al.  The Technology Acceptance Model: Past, Present, and Future , 2003, Commun. Assoc. Inf. Syst..

[12]  P H Clarke,et al.  A referrer and patient evaluation of a telepsychiatry consultation–liaison service in South Australia , 1997, Journal of telemedicine and telecare.

[13]  David P Mackinnon,et al.  Resampling and Distribution of the Product Methods for Testing Indirect Effects in Complex Models , 2008, Structural equation modeling : a multidisciplinary journal.

[14]  C. Delaplain,et al.  Tripler pioneers telemedicine across the Pacific. , 1993, Hawaii medical journal.

[15]  R. MacCallum,et al.  Power analysis and determination of sample size for covariance structure modeling. , 1996 .

[16]  P. Mclaren,et al.  Telepsychiatry in an inner-city community psychiatric service , 1996, Journal of Telemedicine and Telecare.

[17]  Roderick P. McDonald,et al.  THE THEORETICAL FOUNDATIONS OF PRINCIPAL FACTOR ANALYSIS, CANONICAL FACTOR ANALYSIS, AND ALPHA FACTOR ANALYSIS , 1970 .

[18]  K. Schermelleh-Engel,et al.  Evaluating the Fit of Structural Equation Models: Tests of Significance and Descriptive Goodness-of-Fit Measures. , 2003 .

[19]  Sarah Muttitt,et al.  Integrating telehealth into Aboriginal healthcare: the Canadian experience , 2004, International journal of circumpolar health.

[20]  Viswanath Venkatesh,et al.  Determinants of Perceived Ease of Use: Integrating Control, Intrinsic Motivation, and Emotion into the Technology Acceptance Model , 2000, Inf. Syst. Res..

[21]  D. Goldstein,et al.  The utility of videoconferencing to provide innovative delivery of psychological treatment for rural cancer patients: results of a pilot study. , 2006, Journal of pain and symptom management.

[22]  James E. Mitchell,et al.  Psychotherapy for bulimia nervosa delivered via telemedicine , 2003 .

[23]  William R. King,et al.  A meta-analysis of the technology acceptance model , 2006, Inf. Manag..

[24]  H. Marsh,et al.  In Search of Golden Rules: Comment on Hypothesis-Testing Approaches to Setting Cutoff Values for Fit Indexes and Dangers in Overgeneralizing Hu and Bentler's (1999) Findings , 2004 .

[25]  Timothy Kwok,et al.  Cognitive intervention for community‐dwelling older persons with memory problems: telemedicine versus face‐to‐face treatment , 2005, International journal of geriatric psychiatry.

[26]  David P Mackinnon,et al.  Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods , 2004, Multivariate behavioral research.

[27]  J. Elhai,et al.  Therapist Adherence and Competence With Manualized Cognitive-Behavioral Therapy for PTSD Delivered via Videoconferencing Technology , 2007, Behavior modification.

[28]  Matthew S. Fritz,et al.  PSYCHOLOGICAL SCIENCE Research Article Required Sample Size to Detect the Mediated Effect , 2022 .

[29]  R Benschoter,et al.  Two-way television: helping the Medical Center reach out. , 1972, The American journal of psychiatry.

[30]  B Christopher Frueh,et al.  Current Directions in Videoconferencing Tele-Mental Health Research. , 2009, Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association.

[31]  Susan O'Donnell,et al.  Conversations on telemental health: listening to remote and rural First Nations communities. , 2011, Rural and remote health.

[32]  Christine DiStefano,et al.  The Impact of Categorization With Confirmatory Factor Analysis , 2002 .

[33]  Conor V. Dolan,et al.  Factor analysis of variables with 2, 3, 5, and 7 response categories: A comparison of categorical variable estimators using simulated data , 1994 .

[34]  Gordon W. Cheung,et al.  Testing Mediation and Suppression Effects of Latent Variables , 2008 .

[35]  Kerri Gibson,et al.  Telemental Health with Remote and Rural First Nations: Advantages, Disadvantages, and Ways Forward , 2009 .

[36]  Stéphane Bouchard,et al.  Effectiveness of Cognitive Behavioural Therapy Administered by Videoconference for Posttraumatic Stress Disorder , 2009, Cognitive behaviour therapy.

[37]  Youngjin Yoo,et al.  It's all about attitude: revisiting the technology acceptance model , 2004, Decis. Support Syst..

[38]  S. Simpson Psychotherapy via videoconferencing: a review , 2009 .

[39]  Christopher B Frueh,et al.  Telemedicine for anger management therapy in a rural population of combat veterans with posttraumatic stress disorder: a randomized noninferiority trial. , 2010, The Journal of clinical psychiatry.

[40]  Clare S. Rees,et al.  Therapeutic Alliance in Face-to-Face Versus Videoconferenced Psychotherapy. , 2005 .

[41]  Fred D. Davis Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology , 1989, MIS Q..

[42]  P. Bentler,et al.  Cutoff criteria for fit indexes in covariance structure analysis : Conventional criteria versus new alternatives , 1999 .

[43]  W. Agras,et al.  Ambulatory computer-assisted therapy for obesity: a new frontier for behavior therapy. , 1985, Journal of consulting and clinical psychology.

[44]  Gordon B. Davis,et al.  User Acceptance of Information Technology: Toward a Unified View , 2003, MIS Q..

[45]  John Ingham,et al.  Why do people use information technology? A critical review of the technology acceptance model , 2003, Inf. Manag..

[46]  Stéphane Bouchard,et al.  Assessment of the Therapeutic Alliance in Face-to-Face or Videoconference Treatment for Posttraumatic Stress Disorder , 2009, Cyberpsychology Behav. Soc. Netw..

[47]  T. Little,et al.  On selecting indicators for multivariate measurement and modeling with latent variables: When "good" indicators are bad and "bad" indicators are good. , 1999 .

[48]  K. Courtney,et al.  Exploring underutilization of videophones in hospice settings. , 2007, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[49]  B. Byrne Factor Analytic Models: Viewing the Structure of an Assessment Instrument From Three Perspectives , 2005, Journal of personality assessment.

[50]  E. Nelson,et al.  Feasibility of telemedicine intervention for childhood depression , 2006 .