“I feel like it's just really become second nature, almost like the screen’s not there”: a qualitative case study of the transition to telehealth for home visitation program to support fragile infants due to the COVID-19 pandemic

A subset of early childhood home visitation programs support fragile infants and prevent hospital readmission as infants transition out of the neonatal intensive care unit (NICU) into their home. However, the COVID-19 pandemic initiated an unexpected change in the delivery of home visitation care to adhere to social distancing guidelines, resulting in a rapid transition into telehealth services. In this study, individual semi-structured interviews were conducted with staff from a NICU-transition home visitation program in Arizona. The Modified Technology Acceptance Model (MTAM) was used to evaluate the experiences of in-person to telehealth home visitations during the COVID-19 pandemic. Rapid Qualitative Analysis Method was utilized to generate a thematic analysis. Three major themes were identified: staff-centric, family-centric, and the experience of collective adjustment to the stressors of the pandemic. Participants faced challenges transitioning to telehealth visits, including not being able to physically demonstrate development skills on the infant. However, the telehealth model allowed staff to serve a larger geographic area, as well as allowing them to build a larger caseload as they had more control over their schedule. Staff also noted that families appreciated telehealth home visits as an added layer of health protection for their fragile infants. Because the transition to telehealth was abruptly necessitated by the COVID-19 pandemic, the study participants did not have the option to not use telehealth; thus, in the future, the MTAM framework could benefit from adaptions that address the rapid adoption of technology due to large disruptors such as COVID-19.