Building Resilience and Deconstructing Opioid Use Disorder (OUD) Stigma through Life Narratives in Central Appalachia

iTHRIV Community Organization and Research/Academic Partnership – Our project “Building Resilience and Deconstructing Opioid Use Disorder (OUD) Stigma through Life Narratives in Central Appalachia” aims use qualitative research methods to collect life narratives of people in SWVA who have been affected by the opioid crisis. Our goal is to reduce stigma associated with OUD and improve treatment and prevention programs in the area. This project is done in partnership with One Care of Southwest Virginia and Radford University.   It is presently ongoing.

UVA Patient Preferences on Telepsychiatry During COVID-19 Quarantine

The COVID-19 Pandemic has exacerbated many people’s mental health issues and presented urgent challenges for the US health service system to address mental illness in a safe and effective manner. During quarantine, telemedicine has rapidly evolved to provide increased access to high-quality and cost-effective healthcare. Telepsychiatry is a unique and unfamiliar mode of engaging in various aspects of psychiatric care during the pandemic. However, little is known about the factors that influence patients’ preferences on virtual versus in-person sessions during a public health crisis. Through survey-based investigation of participants in UVA telepsychiatry, we aimed to better understand patients’ experience of virtual healthcare during this pandemic. Our team performed a chart review to select patients seen by UVA psychiatry before July 2019 (when UVA established telepsychiatry appointments) and in April 2020, as these patients had experienced both in-person and virtual modalities of psychiatric care. Eligible patients were contacted to participate in a brief Qualtrics survey. The survey, consisting of multiple-choice and open-ended questions, collected information on patients’ demographic characteristics and preferences on various aspects of their telepsychiatry experience. We defined six dimensions of patient experience as preference towards telepsychiatry, ease of convenience, perceived safety, feeling understood, ability to be emotionally open, and feeling more connected with their therapist. We contacted 867 patients and received 240 responses, a 28% response rate. Middle-aged, white, heterosexual cisgender women constituted the largest sample population. We began our analysis by computing participants’ mean scores of the aforementioned six dimensions on a scale of 1 (prefer in-person) to 5 (prefer virtual). One-way ANOVA indicated that age, gender, and employment status had a significant influence on their preference towards virtual appointments. Specifically, employed, middle-aged, female patients exhibit a more favorable attitude towards telepsychiatry sessions, primarily due to convenience, feeling understood, and ability to open up during their sessions. Based on intersectional analysis, patient-therapist gender match contributes to patients’ more favorable attitude towards telepsychiatry sessions. Among patients with female therapists, female patients felt more connected to their therapists; among patients with male therapists, male patients felt more understood and heard by their therapists. Our study did not show that race, sexual orientation, or the number of dependents as significant influences on patients’ experience. There is limited research on the correlation between patients’ specific demographics and preference for telepsychiatry during the COVID pandemic, and this research project sought to address this gap. The open-response feedback provided personal anecdotes of technical issues with UVA’s telepsychiatry process as well as qualitative support for/against virtual sessions. However, sampling bias was likely present in this study since surveys were completed voluntarily, undermining the external validity of these conclusions. Overall, this observational study promotes telepsychiatry as a safe (socially-distanced) and convenient method of fostering doctor-patient connections that create avenues for emotional vulnerability during the pandemic. Future research would extend the participant cohort to later months in 2020-21 and investigate how preferences on telemedicine may have changed after enduring a prolonged quarantine.

Poster presented at MATRC 2021