The lack of training and education of Community-Based Rehabilitation (CBR) workers poses one of the most significant barriers to receiving effective occupational, physical and speech therapy for individuals with disabilities in Low-to-Middle Income Countries (LMIC), especially in countries with significant refugee populations. The aim of this study was to successfully implement a telehealth support system for CBR workers, evaluate the feasibility and acceptability of this intervention’s implementation among CBR workers in the CBR setting, and further identify strategies to address the deficit of skilled rehabilitation workers in LMIC through technological intervention. This pilot study included CBR workers and CBR managers to inform feasibility, acceptability, and sustainable implementation. The RE-AIM and Dynamic Sustainability Framework were incorporated to guide procedural design, survey development, data collection, data evaluation, and increase success of telehealth implementation. CBR workers participate in trainings, telehealth sessions, surveys and focus groups to inform feasibility and acceptability. CBR Managers participated in focus groups to inform feasibility and sustainable implementation. NVIVO 12 Software was utilized to develop themes from CBR worker and CBR manager responses. Findings from this study demonstrate the need for additional training support for CBR workers in CBR settings throughout the entire treatment process. The telehealth system demonstrated successful short-term implementation across several domains of feasibility. Telehealth utilization was also proven acceptable, appropriate and necessary. Cultural beliefs, CBR worker training, and CBR Center infrastructure pose the most significant barriers to implementation of telehealth technologies in CBR Centers. CBR workers and managers confirmed the demand for future telehealth-based support systems, strengthening effort towards sustainability and scale-up. Telehealth can be utilized to support CBR workers that serve vulnerable and marginalized populations, and in turn improve the global health status among refugee populations by reducing inequitable access to quality health care. The results support the need for further research to rigorously evaluate effectiveness of telehealth interventions to support CBR workers.

中文翻译：

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对难民营中社区康复工作者的可持续支持解决方案：试行远程医疗的可接受性和实施。

缺乏对基于社区的康复（CBR）工人的培训和教育是中低收入国家（LMIC）中残疾人获得有效职业，物理和言语治疗的最大障碍之一有大量难民。这项研究的目的是成功地为社区康复工作者实施远程医疗支持系统，评估在社区康复环境下社区康复工作者实施该干预措施的可行性和可接受性，并进一步确定通过技术解决中低收入国家熟练康复工作者不足的策略。介入。这项初步研究包括社区康复工作者和社区康复经理，以告知可行性，可接受性和可持续实施。RE-AIM和动态可持续性框架被合并以指导程序设计，调查开发，数据收集，数据评估，并提高远程医疗实施的成功率。社区康复工作者参加培训，远程医疗会议，调查和焦点小组，以告知可行性和可接受性。社区康复管理人员参加了焦点小组，以告知可行性和可持续实施。NVIVO 12软件用于根据CBR工作者和CBR经理的回应来制定主题。这项研究的结果表明，在整个治疗过程中，需要在CBR环境中为CBR工人提供额外的培训支持。远程医疗系统展示了跨多个可行性领域成功实施的短期方案。远程医疗利用也被证明是可以接受，适当和必要的。文化信仰，社区康复工作者培训和社区康复中心基础设施构成了在社区康复中心实施远程医疗技术的最大障碍。社区康复工作人员和管理人员确认了对未来基于远程医疗的支持系统的需求，从而加大了实现可持续性和扩大规模的努力。远程医疗可用于支持为弱势和边缘化人群提供服务的社区康复工作者，进而通过减少不平等获得优质医疗服务的机会，改善难民人口的全球健康状况。结果支持需要进一步研究以严格评估远程医疗干预措施以支持社区康复工作者的有效性。社区康复工作人员和管理人员证实了对未来基于远程医疗的支持系统的需求，从而加大了实现可持续性和扩大规模的努力。远程医疗可用于支持为弱势和边缘化人群提供服务的社区康复工作者，进而通过减少不平等获得优质医疗服务的机会，改善难民人口的全球健康状况。结果支持需要进一步研究以严格评估远程医疗干预措施以支持社区康复工作者的有效性。社区康复工作人员和管理人员证实了对未来基于远程医疗的支持系统的需求，从而加大了实现可持续性和扩大规模的努力。远程医疗可用于支持为弱势和边缘化人群提供服务的社区康复工作者，进而通过减少不平等获得优质医疗服务的机会，改善难民人口的全球健康状况。结果支持需要进一步研究以严格评估远程医疗干预措施以支持社区康复工作者的有效性。反过来，通过减少不平等获得优质医疗服务的机会，改善了全球难民的健康状况。结果支持需要进行进一步研究，以严格评估远程医疗干预措施对支持社区康复工作者的有效性。反过来，通过减少不平等获得优质医疗服务的机会，改善了全球难民的健康状况。结果支持需要进一步研究，以严格评估远程医疗干预措施对CBR工作者的支持效果。