Follow-up Probes Research Articles

“Like the Wild West”: Health care provider perspectives on impacts of recreational cannabis legalization on patients and providers at a tertiary psychiatric hospital in Ontario, Canada

IntroductionLegalization has increased cannabis availability in Canada. Research shows complex relationships between cannabis use and mental health, and a need for health care providers to engage with patients about cannabis use. Providers have noted gaps in knowledge and research on the medical effects of cannabis as barriers to service delivery. It is unclear how providers and patients in mental health care settings have been impacted by legalization. MethodsFrom June 1 to July 2, 2021, we conducted a qualitative study involving semi-structured interviews with 20 health care providers in a range of roles (e.g., physicians, pharmacists, nurses) within a psychiatric hospital setting. Participants responded to open-ended questions with follow-up probes on various topics related to cannabis legalization. Topics included impacts on patient mental and physical health, clinical impacts, education and training, legal cannabis retail system and the medical cannabis access system. ResultsThematic analysis identified several themes in the data. Participants reported that legalization has had some positive impacts relating to clinical care and cannabis safety. They also expressed concerns with increased rates of cannabis use, risks to mental health and ongoing challenges engaging with patients about cannabis. Participants made recommendations for medical educators and regulators (e.g., updated curriculums, clinical guidelines), the mental health care sector (e.g., implementation of standardized screening), government (e.g., public health campaigns, safe use guidelines), the medical cannabis access system (e.g., increased regulation, research), and the legal cannabis system (e.g., zoning changes, point-of-sale information). ConclusionsThis study begins to address the paucity of data on impacts of legalization from mental health service delivery settings. Findings show that although legalization has had some positive impacts, there are ongoing patient concerns and unmet provider needs. More research is needed to understand the experiences of providers delivering care to populations experiencing mental health and/or substance use concerns who use cannabis in the post-legalization era.

Development of the Cutaneous Dermatomyositis Investigator Global Assessment (CDM-IGA): A De Novo IGA of Cutaneous Manifestations of Dermatomyositis.

Dermatomyositis (DM) is a rare systemic autoimmune disease characterized by a distinctive debilitating skin rash and skeletal muscle weakness. It is unclear if existing clinical outcome assessment (COA) measures include the concepts of priority to patients and those necessary to fully capture improvements in the active cutaneous manifestations of DM. This study aimed to develop the Cutaneous Dermatomyositis Investigator Global Assessment (CDM-IGA), a de novo IGA, for use in clinical trials of adult DM. Eight DM clinical experts participated in 60-min qualitative interviews consisting of concept elicitation and cognitive debriefing methodologies. Concept elicitation comprised open-ended questions with follow-up probes to explore clinicians' experiences of treating patients with DM, the impact of symptoms on patients' quality of life, and the severity levels of disease characteristics to explore DM progression. Cognitive debriefing required the clinical experts to perform a review of the CDM-IGA, designed to assess the severity of cutaneous disease activity of DM. After the interviews, a consensus meeting with three clinical experts was held to agree on any outstanding issues relating to the CDM-IGA. The CDM-IGA was iteratively developed using the opinions of nine clinical experts. Feedback provided by all clinicians agreed that erythema was the main active cutaneous manifestation of DM and should be the primary characteristic on the CDM-IGA, split by erythema color and extent. To determine cutaneous disease severity, experts suggested adding a metric called secondary changes, which combined erosion/ulceration and lichenification, which could modify the patient's final score. Three clinical experts suggested that a photo-guide to support assessments of erythema across different skin tones could be beneficial. A novel CDM-IGA was developed for use with adult patients with DM in clinical trials, based on an iterative development process that combined qualitative feedback from clinical experts of DM and importantly adult patients living with DM.

Exploring Discrimination Experienced by Secondary Level Students in ELT Classroom: A Narrative Inquiry

This study aims at examining the experiences of discrimination in English language classrooms from the perspective of secondary level students. The research adopted a narrative inquiry approach, conducting individual face-to-face interviews with participants to explore their personal experiences and observations regarding discrimination. We selected four secondary level students from two government schools in the Kathmandu district purposively. We used semi-structured interviews allowing for open-ended questions and follow-up probes to gain deeper insights into participants’ responses.The analysis of the collected data followed a thematic approach. The researchers carefully reviewed the transcribed interview recordings to identify recurring patterns, themes, and key insights related to discrimination in English language classrooms.The findings revealed instances of unequal treatment by teachers, including favoritism based on gender, academic performance, and subjective factors. Participants expressed how such unequal treatment affected their motivation and engagement in the English language classroom. Discrimination based on physical appearance, skin colour, and linguistic competence was also highlighted, demonstrating the negative impact on students’ self-esteem and sense of belonging. Additionally, social hierarchies among peers contributed to exclusion and marginalization, affecting students from less privileged backgrounds.To minimize discrimination in ELT classrooms, the study suggests fostering an inclusive and supportive environment where all students are treated equally and valued for their individual strengths and contributions. Teacher training programs are recommended to promote cultural sensitivity, awareness of biases, and inclusive teaching practices. The importance of creating gender-inclusive curricula and encouraging positive gender socialization is emphasized. The research contributes to the understanding of discrimination in English classrooms by centering on students’ perspectives. The insights gained can inform educational policies and practices aimed at reducing discrimination and promoting equity in English language teaching classrooms.

Cultural Adaptation and Validation of the Self-Efficacy Instrument for Chronic Disease Management in the Chilean Population

To adapt and validate the Latin-Spanish version of the Self-Efficacy to Manage Chronic Disease (SEMCD-S) for the Chilean population. Twenty-one individual cognitive interviews were conducted with adults with diagnosed chronic diseases, comparing the understanding of the SEMCD-S with the Chilean adaptation (SEMCD-S-Ch) using paraphrasing and follow-up probes. Then, 144 adults with diagnosed chronic diseases under control were recruited in three family health centers in La Florida and La Pintana. These participants were administered the SEMCDS-Ch at recruitment, at six weeks, and four months later. An exploratory factor analysis (EFA) was conducted, the internal consistency of the instrument was calculated, and a confirmatory factor analysis (CFA) was performed to validate the EFA findings. The adaptation process incorporated changes in the writing style and some terms used in the SEMCD-S, improving the understanding of the instrument. In the psychometric testing of the SEMCDS-Ch, the AFE identified a single-factor solution, the internal consistency in each of the administrations was very good (α between 0.849 to 0.878), and the CFA confirmed the unidimensional structure of the instrument relatively well. The SEMCD-S-Ch is understandable, reliable, and useful for a brief and competent assessment of self-efficacy in people with chronic diseases under control in primary health care.

A qualitative assessment of the eResearch Knowledge Centre’s support practices in the Human Sciences Research Council in Pretoria, South Africa

PurposeThis paper aims to assess whether the current eResearch Knowledge Centre’s (eRKC) research support practices align with researchers’ requirements for achieving their research objectives. The study’s objectives were to assess the current eRKC research support services and to determine which are adequate and which are not in supporting the Human Sciences Research Council (HSRC) researchers.Design/methodology/approachThis study uses interviews as part of the qualitative approach. The researcher chose to use interviews, as some aspects warranted further explanation during the interview. The interviews were scheduled using Zoom’s scheduling assistant. The interviews were semi-structured, guided by a flexible interview procedure and supplemented by follow-up questions, probes and comments. The research life cycle questions guided the interviews. The data obtained were coded and transcribed using MS Excel. The interview data were analysed, using NVivo, according to the themes identified in the research questions and aligned with the theory behind the study. Pre-determined codes were created in line with the six stages of the research life cycle and applied to group the data and extract meaning from each category. Interviewee responses were assigned to groups in line with the stages of the research life cycle.FindingsThe current eRKC research support services are aligned with the needs of HSRC researchers and highlight services that could be expanded or promoted more effectively to HSRC researchers. It proposes a new service, data analysis, and suggests that the eRKC could play a more prominent role in research impact, research data management and fostering collaboration with HSRC research divisions.Research limitations/implicationsThis study is limited to assessing the eRKC’s support practices at the HSRC in Pretoria, South Africa. A more comprehensive study is needed for HSRC research services, capabilities and capacity.Practical implicationsAssessment of eRKC followed a comprehensive interviewee schedule that followed Raju and Schoombee’s research life cycle model.Social implicationsZoom’s scheduling assistant may have generated Zoom fatigue and reduced productivity. Technical issues, losing time, communication gaps and distant time zones may have affected face-to-face interaction.Originality/valueeRKC research support practices are rare in South Africa and most parts of the world. This study bridges the gap between theory and practice in assessing eRKC research support practices.

Exploring medical and veterinary student perceptions and communication preferences related to antimicrobial resistance in Ontario, Canada using qualitative methods

BackgroundAntimicrobial resistance (AMR) threatens our ability to treat and prevent infectious diseases worldwide. A significant driver of AMR is antimicrobial use (AMU) in human and veterinary medicine. Therefore, education and awareness of AMR among antimicrobial prescribers is critical. Human and animal health professionals play important roles in the AMR issue, both as contributors to the emergence of AMR, and as potential developers and implementers of effective solutions. Studies have shown that engaging stakeholders prior to developing communication materials can increase relevance, awareness, and dissemination of research findings and communication materials. As future antimicrobial prescribers, medical and veterinary students’ perspectives on AMR, as well as their preferences for future communication materials, are important. The first objective of this study was to explore medical and veterinary student perceptions and understanding of factors associated with emergence and spread of AMR. The second objective was to identify key messages, knowledge translation and transfer (KTT) methods, and dissemination strategies for communication of AMR information to these groups.MethodsBeginning in November 2018, focus groups were conducted with medical and veterinary students in Ontario, Canada. A semi-structured format, using standardized open-ended questions and follow-up probing questions was followed. Thematic analysis was used to identify and analyze patterns within the data.ResultsAnalyses showed that students believed AMR to be an important global issue and identified AMU in food-producing animals and human medicine as the main drivers of AMR. Students also highlighted the need to address society’s reliance on antimicrobials and the importance of collaboration between different sectors to effectively reduce the emergence and transmission of AMR. When assessing different communication materials, students felt that although infographics provide easily digestible information, other KTT materials such as fact sheets are better at providing more information without overwhelming the target audiences (e.g., professional or general public).ConclusionOverall, the study participants felt that AMR is an important issue and emphasized the need to develop different KTT tools for different audiences. This research will help inform the development of future communication materials, and support development of AMR-KTT tools tailored to the needs of different student and professional groups.

Evaluation of a Telehealth Training Package to Remotely Teach Caregivers to Conduct Discrete-Trial Instruction

The present study evaluated the effectiveness of using telehealth technologies to remotely train caregivers of children with ASD to conduct discrete-trial instruction (DTI). We used a multiple-baseline-across-participants design to evaluate caregiver correct implementation of the DTI procedures and child emission of independent correct tacts as dependent measures. We observed robust and immediate improvements for all three caregivers and two of three children. Treatment effects were maintained during follow-up and generalization probes. We discuss the benefits of telehealth technologies and other remote treatment applications.

Teaching Science Facts to Students with Autism Spectrum Disorders via Telehealth.

The interruption in the education of students with autism spectrum disorders (ASD) during the COVID-19 pandemic has necessitated telehealth services offered both to the individuals and their parents. Therefore, this study aimed to examine the effects of the simultaneous prompting procedure and observational learning in teaching science facts to middle-school students with ASD by using multiple probe designs with probe trials via telehealth. The researchers also conducted follow-up and novel adult probe sessions to assess the effects of simultaneous prompting procedure and observational learning along with the opinions of students and their mothers in terms of social validity. Results indicated that students acquired the target science facts and observational learning skills, maintained them over time, and generalized them across different people. The implication of the findings and directions for future research was additionally discussed.

Teaching Compassion Skills to Students of Behavior Analysis: A Preliminary Investigation.

Socially valid practices are at the heart of applied behavior analysis and can influence how interventions are experienced by families. However, the training of practitioners of applied behavior analysis is primarily focused on the implementation of technical procedures with little focus on therapeutic approaches. Empathy and therapeutic rapport have been associated with improved outcomes in allied professions (Beach et al., Journal of the American Board of Family Practice, 15(1), 25–38, 2006; Hojat et al., Academic Medicine, 86(3), 359, 2011; Horst et al., Journal of Child & Family Nursing, 3, 5–14, 2000), but have been minimally studied within the field of behavior analysis. In the present study, several sources were utilized to identify and define empathic and compassionate care skills. These skills were divided into three skill areas (i.e., basic interviewing skills, interest in the family, joining with the family) and taught to ABA master’s students using behavioral skills training via a telehealth platform. All four participants significantly improved their engagement in compassionate care skills following training and maintained these skills in follow-up probes and with a different experimenter. Several post-study measures of outcome were taken, including social validity measures from participants, ratings of compassion from consumer and professional experts, as well as comparison measures on the Jefferson Scale of Physician Empathy. Participant reports of social validity were high, as were consumer and professional ratings of compassionate behaviors. Improvements on the Jefferson Scale of Physician Empathy were also observed. Implications for training practitioners and for expanding the focus on compassionate care skill development within the field are explored.

Teaching Joint Attention: Assessing Generalization and Maintenance of Effects using Multiple Exemplar Training.

The purpose of the present study was to evaluate the effects of multiple exemplar training and social reinforcement on the maintenance and generalization of joint attention initiations across toy classes. Three children with autism spectrum disorder (ASD) participated. After analyzing samples of joint attention initiations from neurotypical peers, a composite score was developed and used to evaluate joint attention initiations of the children with ASD. Gaze shifting and commenting were taught using social reinforcement in a multiple exemplar format. Training sessions were followed by probes of untrained stimuli both within and across toy classes. Results showed that the participants acquired both gaze shifting and commenting using social consequences as reinforcers. Following training, participants initiated joint attention with a frequency within the range of their typically developing peers. Multiple exemplar training was also effective in facilitating acquisition within classes and joint attention maintenance during follow-up probes. Additionally, all participants generalized the acquired skills to a class of untrained stimuli.

The Effects of Using Video-Clip Stimuli in Response Elaboration Training in Persian Speakers with Chronic Broca’s Aphasia

ABSTRACT Background The use of pictographic images to elicit spoken language productions is common in aphasia therapy. However, investigations on the treatment effects of using video stimuli are limited. People with aphasia are likely to want to be able to communicate better about content depicted in video-clip segments, especially with the growing popularity of video sharing between friends and family on social media. Aims The aim of this study was to examine the effects of utilising video-clip segments in the provision of Response Elaboration Training (RET; Kearns, 1985) in the Persian language. Specifically, the study addressed four questions: (1) Will the provision of RET with video-clips as the treatment stimuli increase the number of correct information units (CIUs; Nicholas and Brookshire, 1993) Persian speakers with aphasia produce in response to trained stimuli? (2) Will there be an increase in the number of CIUs participants produce in response to untrained stimuli? (3) Will treatment gains be maintained over time? (4) Will the participants exhibit improved scores on the Persian Western Aphasia Battery (Nilipour et al., 2014) from pre- to posttreatment? Methods & Procedures Two participants with moderately severe chronic Broca’s aphasia due to a left-hemisphere stroke received treatment three times a week. A single-case multiple-probe design consisting of two consecutive treatment phases, periodic generalisation probes, and three posttreatment follow-up probes (one-week, three-weeks, and six-weeks) was used. Treatment sessions consisted of two rounds of RET applied to 10 video-clip stimuli. Outcomes & Results Participant 1 reached the treatment termination criteria after six therapy sessions in the first phase of treatment and after seven treatment sessions in the second phase. Participant 2 reached the termination criteria for the first and second treatment phases after 12 and eight treatment sessions, respectively. Large positive treatment effects were found for the participants for trained items. Treatment effects were maintained above baseline performance for trained items on all follow-up measures. Generalisation to untrained items was limited. Both participants exhibited an Aphasia Quotient increase posttreatment on the Persian Western Aphasia Battery, with the largest improvement identified on the spontaneous speech subtest. Conclusion Although preliminary, this study provides support for the use of video stimuli in the provision of RET in the Persian language to individuals with chronic Broca’s aphasia. The study encourages further exploration on the topic and discusses clinical implications of the research.

"Knowledge Without Action Means Nothing": Stakeholder Insights on the Behaviors That Constitute Positive Change for Adults Who Stutter.

The aim of this study was to document the behaviors that adults who stutter (AWS) may engage in to make positive changes to living with stuttering. We interviewed 23 key stakeholders, including 11 AWS and 12 speech-language pathologists who specialize in stuttering therapy. The semi-structured interviews began with the primary question, "If an adult who stutters was making positive changes to living with stuttering, what would they be doing?" Follow-up probing questions focused the interviews on identifying actionable behaviors that would suggest positive changes. The interviews were transcribed and qualitatively analyzed using applied and reflexive thematic analyses to develop multilevel themes. Meaningful units extracted from the interviews contributed to three high-order global themes: (a) noticing and adjusting physical behaviors involved in speaking, to the extent that it is personally important to do so; (b) developing neutral or positive thoughts and feelings about stuttering; and (c) participating more fully in social and professional activities, even if the person stutters or thinks they might stutter. We developed 35 low-order basic themes, which we grouped into 11 mid-order organizing themes, to richly illustrate the three global themes. These findings extend the ongoing discussion regarding best practices for therapy targets in stuttering intervention. We identified measurable, multidimensional actions that clinicians can integrate in their therapy plans with AWS. While these actions represent a holistic approach to making positive changes, it grants clients and clinicians space to develop individualized intentions and outcomes.

Decreasing nervous habits during public speaking: A component analysis of awareness training

Awareness training can produce decreases in nervous habits during public speaking. A systematic replication of Montes et al. (2020) was conducted to evaluate the independent and additive effects of awareness training components (i.e., response description, response detection) on speech disfluencies during public speaking. We extended prior research by evaluating response description alone, delivering the intervention virtually, using novel videos and speech topics during training, and measuring collateral effects on untargeted responses and speech rate. Response description was sufficient at reducing speech disfluencies for 4 of 9 participants. Response detection (video training) was necessary for 2 participants, and the subsequent addition of response detection (in-vivo training) was necessary for 3 participants. Reductions were maintained during follow-up and generalization probes for most participants. Collateral effects of awareness training components were idiosyncratic. A post-hoc analysis revealed that response description, when effective as a stand-alone intervention, may be more efficient than the full awareness training package.

Using transcranial direct current stimulation (tDCS) on the dorsolateral prefrontal cortex to promote long-term foreign language vocabulary learning

Transcranial direct current stimulation (tDCS) on the dorsolateral prefrontal cortex (DLPFC) was used to improve foreign-langue learning while using mental imagery. Participants underwent two sessions of 1 mA, 1.5 mA, or sham stimulation prior to learning Swahili-English word pairs two consecutive days. During learning, participants were encouraged to create a mental image of the associated English word. Twenty-four hours after learning and one week later, participants received a cued recall test. A linear dose–response effect of stimulation was found across both tests that occurred long after the immediate effects of stimulation. Follow-up comparisons revealed that only the 1.5 mA condition differed from the sham group. Exploratory moderating effects revealed interactions with sleep quality and handedness. Those with poorer sleep and who were left-handed showed greater recall after 1.5 mA of stimulation than those with better sleep and right-handers. A follow-up behavioral study probing strategy usage indicated that mental imagery strategy use did not strongly impact learning but point to other possible mechanisms including the importance of attending to multimodal perceptual details and memory consolidation. This preliminary evidence supports the role of the DLPFC or connected regions in foreign language vocabulary learning and verbal memory encoding.

Examination of the Effectiveness and Acceptability of a Play-Based Sibling Intervention for Children with Autism: A Single-Case Research Design.

Complementary and reciprocal interactions are a defining feature of sibling relationships for young children. However, the social and communication difficulties of children with autism spectrum disorder (ASD) can make reciprocal play more difficult and play between siblings can be less rewarding. Sibling play can serve an important role in intervention and family cohesiveness, but there is no consistent method for involving siblings in intervention benefitting the sibling dyad. This study evaluated a novel treatment package including training siblings on play strategies to increase positive sibling play in combination with a sibling support group to offer social support for the neurotypical sibling (NT). The effects of the treatment package on NT sibling play and fidelity of implementation of naturalistic play strategies was examined using a concurrent multiple-baseline design across six dyads, five of whom completed the intervention. After behavior skills training, all NT siblings increased the number of strategies they used, and increased the frequency of initiations towards their sibling with ASD. In addition, the percentage of reciprocal play between siblings increased. Generalization probes and follow-up probes demonstrated above-baseline levels of performance across most dyads, indicating that the skills learned generalized across other toys and were maintained over time. Only three of the sibling support group sessions were completed due to the COVID-19 pandemic. Although the effectiveness of the sibling support group cannot be determined, social validity questionnaires suggest siblings and parents valued and liked the support group.Supplementary InformationThe online version contains supplementary material available at 10.1007/s43494-021-00043-5.

The Use of a Brief Treatment Package to Increase Session Note Completion in an ABA Agency

ABSTRACT The number of Board Certified Behavior Analysts® (BCBAs) has grown exponentially over the last two decades, with the majority of practitioners providing services to individuals with autism spectrum disorder (ASD) and their families. Although there are different funding mechanisms for services provided by a BCBA®, third-party payers and insurance companies are increasingly providing coverage for these services. Clinical documentation, such as session notes on client progress, are typically required by funders of such services. Additionally, complete session notes can lead to effective coordination of care and recording client response to treatment. In this study, a treatment package consisting of a sample note, self-monitoring, and feedback was utilized to improve the completion of session notes of six technicians in an ABA agency serving individuals with ASD. Results indicate that the procedure was rapidly effective in increasing the number of items completed on the notes for all technicians, and this improvement was maintained at 1 and 2-week follow-up probes.

N04 Being an IBD Clinical Nurse Specialist in the UK National Health Service: Challenges, Stressors and Coping Mechanisms

Abstract Background Inflammatory Bowel Disease Clinical Nurse Specialists (IBD-CNSs) provide essential therapeutic and emotional support services to patients with often complex disease. The ever-increasing role expectations, treatment modalities and rising patient population places significant demands on IBD-CNSs (Stansfield, 2019), many of whom enter the role soon after qualifying. Posts in the UK-based RCN IBD Nurse Facebook© page suggest stress is high amongst members. Sustaining IBD-CNSs wellbeing is essential for ensuring sustainability of services. Our aim was to explore experiences of being an IBD-CNS in the UK, in order to inform the wider dialogue around workforce and the wellbeing of specialist nurses. Methods This hermeneutic phenomenological study used purposive sampling with maximum variation to recruit Band 6–8 IBD-CNSs who currently, or until recently, worked in NHS Trusts across the UK. Data were collected between July and September 2020, via online or telephone interviews. Focussing on personal perceptions, participants were invited to ‘Tell me what it means to be an IBD-CNS’ with follow-up prompts and probes as needed. Diekelmann et al’s (1989) team analysis method was used. Results Twenty-five IBD-CNSs participated [92% Female; Band 6 (n=3), Band 7 (n=10), Band 8 (n=13); 0.5–19 (mean 5.8) years in post; ex-NHS (n=4)]. Two constitutive patterns: ‘Giving and receiving support’, and ‘Developing potential’ were revealed, informed by relational themes addressing patients’ needs, service design/delivery challenges, workload, professional development opportunities, and peer support. Junior IBD-CNSs worried more about workload and learning the role, whilst senior nurses often struggled with the shift towards management responsibilities which they were expected to take on often without any managerial skills or training. The IBD-CNS role was often poorly understood by senior service managers, whose level of support varied widely. Some participants had techniques to mitigate against stressors, but there were also limited professional development opportunities especially in senior roles. Conclusion IBD-CNSs are committed to patients, despite an often-burdensome workload. Structural, institutional, and hierarchical issues undermine confidence. Many IBD-CNSs are stressed by mixed messages of delivering an excellent service yet being criticised/under-appreciated by the system. Robust senior support structures lead to better experiences for IBD-CNSs. This work contributes to the UK and global data evidencing the need to pursue strategies which promote wellbeing of all specialist nurses.

E&P Notes (May 2021)

E&P Notes (May 2021)

Training human service staff to implement behavioral skills training using a video-based intervention.

The current study evaluated the efficacy of a video-based training to teach 4 staff working in a human service setting to use behavioral skills training (BST) to teach job-related skills to others. Low levels of BST integrity were observed during baseline. Immediately after viewing a 13-min training video, 2 participants implemented BST at mastery (i.e., 100% integrity). The remaining 2 participants required brief supplemental performance feedback to reach criterion performance. The effects of the training generalized to training 2 novel skills and maintained in follow-up probes conducted 1 to 4 weeks posttraining. A social validity measure indicated high levels of satisfaction with the video-based training and high acceptability of BST. Implications of these findings for organizational training practices and directions for future research are discussed.

Patient experiences with telehealth in sleep medicine: a qualitative evaluation.

The field of sleep medicine has been an avid adopter of telehealth, particularly during the COVID-19 pandemic. The goal of this study was to assess patients' experiences receiving sleep care by telehealth. From June 2019 to May 2020, the authors recruited a sample of patients for semi-structured interviews, including patients who had 1 of 3 types of telehealth encounters in sleep medicine: in-clinic video, home-based video, and telephone. Two analysts coded transcripts using content analysis and identified themes that cut across patients and categories. The authors conducted interviews with 35 patients and identified 5 themes. (1) Improved access to care: Patients appreciated telehealth as providing access to sleep care in a timely and convenient manner. (2) Security and privacy: Patients described how home-based telehealth afforded them greater feelings of safety and security due to avoidance of anxiety-provoking triggers (eg, crowds). Patients also noted a potential loss of privacy with telehealth. (3) Personalization of care: Patients described experiences with telehealth care that either improved or hindered their ability to communicate their needs. (4) Patient empowerment: Patients described how telehealth empowered them to manage their sleep disorders. (5) Unmet needs: Patients recognized specific areas where telehealth did not meet their needs, including the need for tangible services (eg, mask fitting). Patients expressed both positive and negative experiences, highlighting areas where telehealth can be further adapted. As telehealth in sleep medicine continues to evolve, the authors encourage providers to consider these aspects of the patient experience. Donovan LM, Mog AC, Blanchard KN, et al. Patient experiences with telehealth in sleep medicine: a qualitative evaluation. J Clin Sleep Med. 2021;17(8):1645-1651.