Journal of Multidisciplinary Healthcare (Dec 2024)
Perceived Barriers and Facilitators of Behavioral-Health Modality Change Adoption During the COVID-19 Pandemic: A Systematic Review
Abstract
Nicholas Sims-Rhodes,1,2 Hannah E Cornwell,1 Emily Barena,3 Vandy Dubre,4 Kimberly S Elliott,5 Eman H Nabulsi,2 Nelly Yuen,3 Sarah M Sass,3 Anastasia Miller,6 Yordanos M Tiruneh,7 Karan P Singh1 1Department of Epidemiology and Biostatistics, University of Texas at Tyler Health Science Center, Tyler, TX, USA; 2Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; 3Department of Psychology and Counseling, The University of Texas at Tyler, Tyler, TX, USA; 4Robert R. Muntz Library, The University of Texas at Tyler, Tyler, TX, USA; 5Department of Healthcare Policy, Economics and Management, University of Texas at Tyler Health Science Center, Tyler, TX, USA; 6Department of Educational Leadership, Evaluation and Organizational Development, University of Louisville, Louisville, KY, USA; 7Department of Preventive Medicine, University of Texas at Tyler Health Science Center, Tyler, TX, USACorrespondence: Nicholas Sims-Rhodes, Department of Psychiatry, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA, Email [email protected]: During the Coronavirus Disease 2019 pandemic, there was a surge in demand for mental health services worldwide, presenting challenges for healthcare institutions as they navigated changes in policy and safety regulations. In the United States, this resulted in many behavioral health modality changes to remain in compliance with the Center for Disease Control guidelines. A growing body of literature has documented these, yet few explored barriers and facilitators affecting the adoption of these modality delivery changes. The researchers conducted a systematic review using the PRISMA method, focusing on service delivery changes across healthcare systems in the United States from March 2020 to May 2022.Objective: The study objective was to identify barriers and facilitators affecting the adoption of changes to modality delivery of behavioral health services due to pandemic restrictions.Methods: This was a systematic review that utilized the PRISMA method. The researchers identified 445 initial articles from eight databases using predetermined keywords and implemented a three-round screening process to select the most pertinent articles for this review. The researchers used a thematic analysis focused on user-related, program-related, technology, and environment-related constructs relevant to engagement with digital mental health interventions, and also addressed provider and administrative-related barriers and facilitators of virtual behavioral health modality changes. Barriers and facilitators were operationalized using the Borghouts Model.Results: This systematic review revealed several common barriers and facilitators, including underdeveloped technology infrastructure, privacy and confidentiality concerns, poor technology literacy, availability of diverse technology options, provider technology training, and ease of integration into everyday life.Conclusion: This review provides insights into barriers and facilitators of modality change adoption, which could inform the development and implementation of virtual mental healthcare services and may help optimize the application of these services by improving our understanding and ability to overcome barriers influencing their adoption.Keywords: telehealth, digital mental health, alternative modalities, telemental health, technology adoption, care delivery challenges, Borghout model barriers and facilitators to technology adoption, COVID-19, PRISMA method
