Itâs not one size fits all: a case for how equity-based knowledge translation can support rural and remote communities to optimize virtual health care
Notice bibliographique
Résumé
CONTEXT: People living in rural and remote British Columbia (BC) in Canada experience complex barriers to care, resulting in poorer health outcomes compared to their urban counterparts. Virtual healthcare (VH) can act as a tool to address some of the care barriers, including reducing travel time, cost, and disruptions to people's lives. Conversely, VH can exacerbate inequities through unique difficulties in rural implementation, such as a lack of access to necessary infrastructure (eg internet), social supports, and technological capacity (eg devices and literacy). ISSUE: The impacts of the COVID-19 pandemic induced a rapid shift to VH, providing new opportunities for health care while simultaneously highlighting and exacerbating inequities for people living in rural and remote settings. Equity-informed knowledge translation processes can help address these concerns. This commentary reports on an equity-informed knowledge translation process engaged by a diverse group of health researchers, community members, and practitioners in BC. LESSONS LEARNED: Informed by equity principles from the Canadian Coalition for Global Health Research, this knowledge exchange and translation process led to the co-creation of two practical tools: a set of VH appointment tip sheets and an open access report. Through stakeholder engagement and literature consultation, VH appointments were found to have many benefits for those in rural and remote communities, including expanding access to basic and specialized health services. However, some hesitation was noted when relying solely on these modes of care, as they can lack relationality, clarity, and time to process medical information. The tip sheets resulting from this process are an interactional-level tool developed to address this concern and optimize VH appointments, for rural patients and care providers. They offer the respective stakeholder group insights on how to actively prepare for and participate in inclusive virtual care. On a systems level, there is a continually echoed need for equity-based processes to ensure that VH is striking the balance of meeting rural health needs without exacerbating inequities. Additionally, incorporating the voices of rural and remote community members is essential. To help address this gap, an open-access report was compiled to serve as a small-scale example of integrating rural voices with existing literature to recommend systems-level adjustments. Overall, VH holds promise as an effective tool for addressing inequities experienced by those living in rural areas. To maximize this potential, rural and remote stakeholders must be proactively engaged and listened to throughout the processes of considering, planning, and implementing shifts in the utilization of VH options.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,076 | 0,099 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,024 | 0,049 |
| Communication savante | 0,025 | 0,033 |
| Science ouverte | 0,006 | 0,022 |
| Intégrité de la recherche | 0,021 | 0,024 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».