An exploration of parents' and health care providers' experiences of telehealth and health visiting services during the COVID-19 pandemic

Abstract

Health visiting services provide universal care, education, and support to families from pregnancy through to school age children. The COVID-19 pandemic changed the way health and care organisations, including health visiting, delivered services. Telehealth was a key part of this change.

This PhD adopted a pragmatist methodology and used mixed methods to explore health visiting staffs’ and parents’ experiences of telehealth and health visiting during COVID-19. An integrative systematic literature review explored experiences of telehealth in the first 1001 days (of life) during COVID-19. The 23 included papers provided limited data on telehealth and health visiting.

Following the review, two empirical studies were undertaken, focused on telehealth and health visiting experiences during the pandemic in the North of England: a qualitative exploration of health visiting staffs’ and a mixed-methods study of parents ‘experiences. Between 2023 and 2024, 15 members of staff from a health visiting service participated in interviews and 72 parents took part in a questionnaire, and 14 of whom also participated in an interview.

The results of the staff and parent experience studies were integrated using a convergence synthesis. Four key domains were noted: health visiting should take place in the home, the importance of relationships, limited benefits of telehealth, and discrepancies in understanding of health visiting services and roles.

Telehealth had some limited benefits for respondents, namely, maintaining contact between families and staff, specific elements of service delivery and provision of timely access to information. However, there was a misalignment between telehealth and the purpose of health visiting, for which home visiting was seen to be fundamental. This includes, assessing and responding to individual needs, safeguarding, and providing relationship-based support.

This thesis contributes new knowledge on the nature and meaning of health visiting services for both families and staff, highlighted by experiences of telehealth during the COVID-19 pandemic. It could therefore inform the future design of a service which provides universal support to families in a critical period of development for children, and time of transition for parents, including the appropriate, limited use of telehealth.