Perceived Facilitators and Barriers, From the Perspective of Users, of a Multicomponent Intervention in Older People Using an Asynchronous Telehealth Modality During the COVID-19 Pandemic: A Qualitative Research

Abstract

Objective: The COVID-19 pandemic interrupted multicomponent face-to-face interventions with older people, which became an opportunity for the implementation of these interventions in telehealth modality, as well as the analysis of the facilitators and barriers. This qualitative study examines the facilitators and barriers, from the users' perspective, of a promotional-preventive multicomponent intervention in older people using an asynchronous telehealth modality during the COVID-19 pandemic, as a continuation of the face-to-face intervention. Methods: Semistructured in-depth interviews were used. An intentional sampling was conducted over eight groups of older people in a city, who were part of a multicomponent (physical activity, cognitive stimulation, and education) telehealth (videos, infographics, manual, and WhatsApp) promotional-preventive intervention, who came from the same face-to-face intervention. After intervention, two groups were identified (intervention and control). Telephone interviews, until theoretical saturation was reached, were audio-recorded and transcribed. Thematic analysis was conducted using Atlas.ti. Results: Twenty-six older people of both sexes, aged 60-88 years, were interviewed (14 intervened and 12 controls). Six themes were identified: positive aspects of telehealth, telehealth facilitators, preference for face-to-face modality over telehealth modality, telehealth barriers, reasons for not performing telehealth, and coping strategies in the pandemic: specifically, as facilitators, participating in the company of others, having participated in the same intervention previously (face-to-face modality), good knowledge of digital literacy, self-motivation, commitment to the program, and the emergence of innate leaders, and as barriers, pain during physical activity, complexity of cognitive exercises included in cognitive stimulation, poor digital literacy, and not having support from others. Conclusion: This is the first qualitative study that identifies facilitators and barriers of a multicomponent intervention in an asynchronous telehealth modality, as a continuation of the same face-to-face intervention. The asynchronous telehealth modality could be used regularly with older people in rural areas, in situations of disability and/or with care needs, pandemic scenarios, or natural disasters.

Keywords: COVID-19; barriers; facilitators; multicomponent; older people; telehealth.

Figure 1

Recruitment flow diagram.

Figure 2

Protocol of the multicomponent intervention in asynchronous telehealth modality.

Figure 3

Diagram illustrating themes.

Figure 4

Scheme summarizing the implications of the multicomponent intervention in the asynchronous telehealth modality, on the basis of reported information provided by older people (intervention group and control group).