背景:数字排除,以缺乏对数字技术的访问为特征,连通性,或数字技能,对边缘化群体的影响不成比例。受数字排斥影响的一个重要领域是获得医疗保健。在新冠肺炎期间,医疗保健服务不得不限制面对面的接触,以限制病毒的传播。随后向远程提供精神卫生保健的转变加剧了数字鸿沟,获得远程精神保健服务的机会有限。作为回应,卡姆登和伊斯灵顿国家卫生服务基金会信托基金启动了创新的数字包容计划(DIS)。
目的:本研究旨在研究促进数字包容对心理健康的影响。卡姆登和伊斯灵顿国家卫生服务基金会信托基金为被数字排除在外的服务用户实施了全信任范围的DIS,也就是说,没有设备或连接,或者报告的数字技能很差。该计划提供了对贷款数字设备(平板电脑)的访问权限,互联网连接设备,和移动数据,以及个性化的数字技能支持。
方法:DIS于2021年10月上线,到2022年6月收到106份转介。对12名服务用户进行了半结构化访谈,询问他们访问综合安全分遣队的经验。主题分析确定了与参与该计划之前的数字排斥程度有关的主题和子主题,以及访问该计划对他们参与数字技术和福祉的能力的影响。
结果:有10个主要主题。共有6个主题与影响参与该计划的因素有关,包括数字排除,与信任的关系,个性化数字支持的重要性,伙伴关系工作,设备可用性和可访问性,和个人情况。其余4个主题谈到了进入该计划的影响,包括改善对服务的访问,对福祉的影响,财务影响,和更大的赋权感。
结论:参与者报告说,对技术的依赖增加,推动了对数字包容性的需求;然而,注意到参与该计划的动机存在差异,以及潜在的障碍,包括缺乏意识,残疾,和年龄。总的来说,据报告,进入综合安全分遣队的经验是积极的,参与者感到支持进入数字世界。参与该计划的后果包括人们更容易获得和控制身心健康护理,改善福祉,和更大的赋权感。提供了经验教训的概述,以及对正在寻求实施类似计划的其他医疗保健机构的建议。
BACKGROUND: Digital exclusion, characterized by a lack of access to digital technology, connectivity, or digital skills, disproportionally affects marginalized groups. An important domain impacted by digital exclusion is access to health care. During COVID-19, health care services had to restrict face-to-face contact to limit the spread of the virus. The subsequent shift toward remote delivery of mental health care exacerbated the digital divide, with limited access to remote mental health care delivery. In response, Camden and Islington National Health Service Foundation Trust launched the innovative Digital Inclusion Scheme (DIS).
OBJECTIVE: This study aimed to examine the impact of facilitating digital inclusion in mental health access. Camden and Islington National Health Service Foundation Trust implemented the trust-wide DIS for service users who were digitally excluded, that is, were without devices or connectivity or reported poor digital skills. The scheme provided access to a loan digital device (a tablet), internet connectivity devices, and mobile data, as well as personalized digital skills support.
METHODS: The DIS went live in October 2021 and received 106 referrals by June 2022. Semistructured interviews were conducted with 12 service users to ask about their experience of accessing the DIS. A thematic analysis identified themes and subthemes relating to the extent of their digital exclusion before engaging with the scheme and the impact of accessing a scheme on their ability to engage with digital technology and well-being.
RESULTS: There were 10 major themes. A total of 6 themes were related to factors impacting the engagement with the scheme, including digital exclusion, relationship to the trust, the importance of personalized digital support, partnership working, device usability and accessibility, and personal circumstances. The remaining 4 themes spoke to the impact of accessing the scheme, including improved access to services, impact on well-being, financial implications, and a greater sense of empowerment.
CONCLUSIONS: Participants reported an increased reliance on technology driving the need for digital inclusion; however, differences in motivation for engaging with the scheme were noted, as well as potential barriers, including lack of awareness, disability, and age. Overall, the experience of accessing the DIS was reported as positive, with participants feeling supported to access the digital world. The consequences of engaging with the scheme included greater perceived access to and control of physical and mental health care, improved well-being, and a greater sense of empowerment. An overview of the lessons learned are provided along with suggestions for other health care settings that are looking to implement similar schemes.