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J. Phelps1, L. Farroni1, S. Fisher1, J. Hoines2, S. Rivera2
1University of Texas Medical Branch, Physical Therapy Department, Galveston, United States, 2Therapy Clinics International, Chichicastenango, Guatemala
Background: Persons with Parkinson’s disease (PWPD) in rural Guatemala have great difficulty accessing needed physical therapy services. The mobility demands of available public transportation are a significant barrier to accessing outpatient physical therapy facilities. Enhancing the delivery of home-based, sustainable physical therapy for PWPD with evidence-based interventions with a sustainable approach could serve to address this needed intervention. The lack of a formal health worker career track and related medical continuing education, as well as a health worker shortage is an ongoing issue in Guatemala. It is vital to provide a quality improvement program to offer training of local rehabilitation providers on effective interventions to serve this population. As an initial needs assessment, Guatemalan healthcare providers’ knowledge of evidence-based practice and confidence in treating PWPD can be examined remotely with the use of widely-available mobile device applications.
Purpose: We aimed to ascertain the effectiveness of gathering data remotely on specific areas of low knowledge and confidence specific to PD interventions that health care providers in rural Guatemala currently possess via mobile device applications and begin to identify key areas for training providers in evidence based and culturally relevant care for PWPD.
Methods: A local physical therapist working with non-governmental organizations recruited health care providers offering care for persons with PD in two departments of Guatemala to participate in the project. The principal investigator conducted a literature review and developed online assessments of knowledge and confidence in treatment of PWPD. We used WhatsApp (WhatsApp Inc., Menlo Park, CA) and Google Forms (Google LLC, Mountain View, CA) to conduct the assessments. We analyzed the utilization of mobile devices by calculating the average response time in days and a percentage of participants completing all steps of the online assessment. The principal investigator used descriptive statistics to highlight key areas for capacity building.
Results: The principal investigator analyzed confidence and knowledge for participants responding to the assessments (N=32) over 18 days. 47% of participants completed all steps with an average response time of 4.5 days. Healthcare provider PD knowledge scores on the knowledge assessment were 45.7±14.1% correct. Intervention areas of lowest knowledge included aerobic exercise, exercises to increase amplitude of movement, and balance training. Overall healthcare provider confidence in treating PWPD, as measured by the confidence assessment, was 58.4±18.4%. There was a negligible relationship between provider knowledge and confidence in treating PWPD.
Conclusion(s): Use of mobile device applications to collect data was effective, with a short response time and moderate rate of assessment completion. Rehabilitation provider confidence and knowledge regarding PD was low in the responding group of healthcare providers. We identified key areas among rural providers for future capacity building in the area of rehabilitation for PWPD.
Implications: This project may inform future attempts at international collaboration via mobile devices between physical therapy programs and non-profit organizations with the goal of implementing sustainable and culturally relevant physical therapy for persons with neurologic disorders.
Funding, acknowledgements: This work was unfunded.
Keywords: m-health, Parkinson’s Disease, Capacity building
Topic: Community based rehabilitation
Did this work require ethics approval? No
Institution: The University of Texas Medical Branch at Galveston
Committee: The Institutional Review Board
Reason: The project did not meet the definition of human research and has been determined to be a quality improvement project.
All authors, affiliations and abstracts have been published as submitted.
