Virtual Home Research Articles

The role of virtual home visits with the use of coaching in early support for the development of children with disabilities during the COVID-19 pandemic

During the COVID-19 pandemic, virtual home visits have become an essential tool in the provision of early support of development of children with disabilities. Thanks to such visits, support can be provided in the natural environment of the child's development and can be focused on the family. Virtual visits forces professionals to apply more coaching strategies to parents and requires parents to engage in a direct relationship with the child. In the first part of the article, the author presents the conditions that must be met for a virtual home visit to take place. Next, he characterizes the course of a virtual visit in accordance with the coaching method. In the third part of the article, the author highlights the most important advantages and disadvantages of virtual home visits.

The Implementation of a Virtual Home Dialysis Mentoring Program for Nephrologists.

Virtual home dialysis physician mentorship is feasible.In total, 53% of participants perceived the program would change the perspective of participants on prescribing home dialysis.More research is needed to ascertain the effect of virtual mentorship on home dialysis incidence and attrition rates in a wider audience.

Empowerment and assistance of Unissula Virtual Homecare (UVHC) volunteers to increase resilience of Covid-19 patients post self-isolation

Prevention and treatment of Covid-19 patients has been carried out with various strategies. Educational strategies can be carried out on patients during self-isolation or after self-isolation. Unissula initiated the Unissula Virtual home care innovation, namely UVHC as an effort to contribute to higher education during the pandemic. The UVHC program needs to be supported by volunteers who can assist Covid-19 patients in increasing their resilience to the problems experienced after Covid-19 so that conditions do not occur again. Assistance and empowerment of UVHC Volunteers aims to increase knowledge, skills and abilities in managing Covid-19 patients after self-isolation. This activity is carried out with training and demonstrations. After the activity, UVHC volunteers increased their knowledge of nutritional needs by 70%, skills in breathing exercises increased to 80%, knowledge of pharmacology needs to 70% and volunteer skills increased by 80% in teaching prayer procedures during illness as an effort to fulfill spiritual needs. The Service Team recommends the formation of volunteers in other fields to increase volunteer awareness in helping the healing process of Covid-19 patients after self isolation

Exploring agreement and feasibility between virtual home visits and in-person home visits for peritoneal dialysis patients—a paired study

Introduction Virtual home visits may improve chronic disease management. However, whether they are suitable for peritoneal dialysis (PD) patients has not yet been fully investigated. This study aimed to compare the agreement and acceptance of virtual home visits and in-person home visits in PD patients. Methods This was a paired, single center, noninferiority trial. Participants received a virtual home visit and an in-person home visit simultaneously. A home visit checklist was built for standardization visits. The content was divided into three parts: domestic habits (57 items), bag exchange procedures (56 items), and exit site care (53 items). Satisfaction questionnaires for both patients and nurses were designed to assess attitudes toward home visits and socioeconomic effects. Results A total of 30 PD patients were enrolled in a single center. The information collected from virtual home visits and in-person home visits was found to be highly consistent. The perfect agreement was found in 52/57, 49/56, and 44/53 items (Cohen's kappa 0.81–1.00), substantial agreement in 4/57, 7/56, and 8/53 items (Cohen's kappa 0.61–0.80). Patients reported almost identical satisfaction for virtual home visits and in-person home visits (Z = 0.39, p = 0.70). PD nurses reported similar feasibility and patient cooperation for the two visit types (Z = 0.99, p = 0.33; Z = 1.65, p = 0.10, respectively). In addition, virtual home visits were found to be more cost-effective than in-person home visits. Conclusions Virtual home visits information collection was similar to in-person home visits in PD. There were no differences in participant satisfaction and feasibility between the two visit types.

Xiaomi and the Promises of the Good Life? Issues of Security and Risk in the Making of the Smart Home in China

Informed by Foucault’s governmentality, this article examines the making of the smart home in China. Operating within the nexus of security and risk, smart homes foster a discourse of the ‘the good life’ that accelerates AI’s integration into the population’s daily life. Taking Xiaomi (a renowned smart home technology company) as a case study, I trace how commercial practices formulate issues of security and risk in three smart home products: smart door lock, home surveillance camera and virtual home assistant. Drawing on visual and discourse analyses of Xiaomi’s promotional materials, this analysis is structured around three levels of relationships: (a) trust and ontological security; (b) the practices of government and the practices of self (c) and the technologisation of Chinese society. This analysis demonstrates that Xiaomi further advances the state-driven technologisation of Chinese society, in which subjects are guided to embrace the positive dimensions of technology for self-actualisation and self-management. However, the technology that makes domestic life and the physical home more reliable, less prone to risks and more secure has at the same time further eroded social relations and trust.

The Transitions to Long-term In Home Ventilator Engagement Study (Transitions to LIVE): study protocol for a pragmatic randomized controlled trial

Background overview and rationaleWe co-developed a multi-component virtual care solution (TtLIVE) for the home mechanical ventilation (HMV) population using the aTouchAway™ platform (Aetonix). The TtLIVE intervention includes (1) virtual home visits; (2) customizable care plans; (3) clinical workflows that incorporate reminders, completion of symptom profiles, and tele-monitoring; and (4) digitally secure communication via messaging, audio, and video calls; (5) Resource library including print and audiovisual material.Objectives and brief methodsOur primary objective is to evaluate the TtLIVE intervention compared to a usual care control group using an eight-center, pragmatic, parallel-group single-blind (outcome assessors) randomized controlled trial. Eligible patients are children and adults newly transitioning to HMV in Ontario, Canada. Our target sample size is 440 participants (220 each arm). Our co-primary outcomes are a number of emergency department (ED) visits in the 12 months after randomization and change in family caregiver (FC) reported Pearlin Mastery Scale score from baseline to 12 months. Secondary outcomes also measured in the 12 months post randomization include healthcare utilization measured using a hybrid Ambulatory Home Care Record (AHCR-hybrid), FC burden using the Zarit Burden Interview, and health-related quality of life using the EQ-5D. In addition, we will conduct a cost-utility analysis over a 1-year time horizon and measure process outcomes including healthcare provider time using the Care Coordination Measurement Tool. We will use qualitative interviews in a subset of study participants to understand acceptability, barriers, and facilitators to the TtLIVE intervention. We will administer the Family Experiences with Care Coordination (FECC) to interview participants. We will use Poisson regression for a number of ED visits at 12 months. We will use linear regression for the Pearlin Mastery scale score at 12 months. We will adjust for the baseline score to estimate the effect of the intervention on the primary outcomes. Analysis of secondary outcomes will employ regression, causal, and linear mixed modeling. Primary analysis will follow intention-to-treat principles. We have Research Ethics Board approval from SickKids, Children’s Hospital Eastern Ontario, McMaster Children’s Hospital, Children’s Hospital-London Health Sciences, Sunnybrook Hospital, London Health Sciences, West Park Healthcare Centre, and Ottawa Hospital.DiscussionThis pragmatic randomized controlled single-blind trial will determine the effectiveness and cost-effectiveness of the TtLIVE virtual care solution compared to usual care while providing important data on patient and family experience, as well as process measures such as healthcare provider time to deliver the intervention.Trial registrationClinicalTrials.gov NCT04180722. Registered on November 27, 2019.

Home Visiting Services During the COVID-19 Pandemic: Program Activity Analysis for Family Connects.

PurposeEarly reports highlighted challenges in delivering home visiting programs virtually during the COVID-19 pandemic but the extent of the changes in program implementation and their implications remains unknown. We examine program activity and families’ perceptions of virtual home visiting during the first nine months of the pandemic using implementation data for Family Connects (FC), an evidence-based and MIECHV-eligible, postpartum nurse home visiting program.DescriptionAggregate program implementation data for five FC sites for January-November of 2019 and 2020 are compared. The COVID-19 Modification Survey is used to analyze families’ reactions to virtual program delivery.AssessmentPost-pandemic onset, FC’s program completion rates amounted to 86% of the pre-pandemic activity level. Activity in key components of the intervention—home-visitor education and referrals to community agencies—was maintained at 98% and 87% of the pre-pandemic level respectively. However, education and referrals rates declined among families of color and low-income families. Finally, families reported a positive response to the program, with declines in feelings of isolation and increases in positive attitudes toward in-person medical care-seeking due to FC visits.ConclusionsDuring the first nine months of the COVID-19 pandemic, families’ interest in home visiting remained strong, performance metrics were maintained at high levels, and families responded positively to the virtual delivery of home visiting. Home visiting programs should continue implementation with virtual modifications during the remainder of the pandemic but attention is needed to address growing disparities in access to home visiting benefits among marginalized communities.

Enhancing preschool–home collaboration: lessons from virtual home visit experiences during the COVID-19 outbreak in China

ABSTRACT In the midst of the COVID-19 worldwide pandemic, the virtual home visit became a key strategy among China’s multiple approaches to ensure children’s continuity of learning, sustain teacher-parent-child relationships, and promote home–preschool collaboration. In this study, using a small stories research narrative paradigm to analyze documented family engagement captured in social media data, we explore how early childhood educators relied on frequent, personal connections with children and families through virtual home visits to mitigate the negative effects of preschool closures in China. Results suggest that the exchange of information and socio-emotional supports during virtual home visits supported and enhanced home–preschool relationships. The virtual home visits evolved into a space for connection and collaboration between the educators and families. We use an ecological-exchange framework to discuss the implications of virtual home visit experiences across time and reflect on pedagogy and practice to enhance development of teachers in online interactions with children and families.

Transitions to virtual early childhood home visitation during COVID-19.

COVID‐19 has disrupted many of the preventive service sectors designed to promote infant mental health. The purpose of this study is to examine provider and supervisor transition strategies as well as maternal‐child outcomes during the transition from in‐person to virtual early childhood home visitation services in Los Angeles County. Los Angeles County is one of the largest home visitation sectors in the U.S. and disproportionately impacted by the COVID‐19 pandemic. Transitioning from in‐person to virtual home visitation was an important step in ensuring the continuity of infant mental health services. Home visitors reported relative ease in transitioning to virtual services themselves but noted that families encountered greater difficulty. The most helpful strategies to support this transition included training, ongoing reflective supervision, and provision of technology. Family level analysis revealed that positive screening rates for anxiety and depression decreased during the pandemic as did referrals for most support services. These findings likely highlight challenges in delivering virtual home visitation. Understanding how transitions in a key infant serving sector were managed serves an important role in forecasting for the future and preparing for future public heath emergencies.

102 Haunted House: The Dangers and Ghosts of The Lived Environment

Accurate assessment of potential hazards and challenges within a home environment is essential to ensure the safety of our patients both post-discharge from hospital and within the community. Inter-professional education in this area allows students to learn from, with and about each other to provide more effective patient care. COVID-19 challenged the Arkansas Interprofessional Education Consortium (ARIPEC) to develop meaningful inter-professional activities while minimizing COVID-19 risk The aim of the study was to create and deliver a novel virtual home assessment simulation for inter-professional learners to improve the performance of home assessments state-wide.Faculty from three universities created rooms within a simulated home assessment environment illustrating patient characteristics, hazards, habits and interpersonal considerations. Each university created and video recorded one simulated room (kitchen, bedroom and living room) which were combined in one video to represent a home. Students received pre-course material including education on the INHOMES tool and learning objectives before the virtual learning event. The brief included education on the importance of home assessment and the INHOMEs tool. The simulated home video was played to all students who subsequently were split into break-out rooms with facilitators. In inter-professional groups, students created action plans for immediate needs and for when weight-bearing status allowed increased mobility and identified professionals required to meet needs. Following this debriefs occurred in break-out rooms and then as a large group to summarize and identify take-aways. All students completed a pre-/post-questionnaire including the Interprofessional Collaborative Competency Attainment Survey (ICCAS) and evaluation of simulation methodology, home assessment and overall impression. Mean scores for 5-point Likert scores are reported.In total, 400 students participated in the 2021 event, including medical, pharmacy, physician assistant, dental hygiene, communication science disorders, physical and occupational therapy, addiction studies, respiratory care, radiography, public health, sonography and nursing. All ICCAS metrics increased pre- to post-evaluation. See Student evaluation data from the simulated home environment assessment activityOur results demonstrate that a video-recorded simulated home environment event is successful in supporting the development of an inter-professional action plan for a home assessment using the INHOMES assessment tool. The collaborative creation of this event was essential due to the COVID-19 pandemic, but the efficacy for learning demonstrates the utility of this approach in the post-pandemic area. Virtual simulations increase accessibility for inter-professional learners to learn from, with and about each other for the benefit of our patients.

Hey Google: A thematic analysis of Twitter users’ comments on the privacy of AI devices in the home

The advancement of technology has been accompanied by the rise of data breaches and privacy concerns. The integration of artificial intelligence (AI)-based virtual assistants into society has led to smart homes that enable users to complete commands instantly. This project uses the diffusion of innovation theory to explain why consumers adopt the technology. A thematic analysis was conducted on Twitter news stories, and open coding showed a strong negative reaction to the stories, with users concluding that privacy was too essential to purchase a virtual assistant for their home. These findings have implications for the future rate of adoption of AI and virtual assistant technology.

Strategies for implementation of virtual home visitation in the United States

Utilising telepractice videoconferencing technology to offer home visitation services has the potential to provide access and parenting support through a high-tech and high-touch service delivery option. Families can receive evidence-based, family support intervention from their home via videoconferencing technology, removing the need for the provider to be physically in the home. While the expansion of telehealth and telepractice services for families is essential for meeting the needs of both parents and their children, well-documented engagement barriers to digital health/computer-mediated interventions exist across treatment modalities and technology platforms. Semi-structured interviews with 15 providers were conducted and analysed to identify engagement strategies utilised to sustain families in a home visitation model offered through live videoconferencing technology on a telehealth platform. Analysis revealed four themes that were deemed essential for successfully attracting and maintaining families in a telepractice-based home visitation programme: (a) engagement strategies to encourage families to participate; (b) clinical skills used within sessions; (c) articulation of benefits to the family; and (d) exploration of rationale for ending services. This study was able to identify strategies for engagement and sustained involvement of families in telehealth-based home visitation. Findings include evidence that providers should be able to move between telehealth and on-ground service provision with relative ease.

Perinatal Mental Health Support and Early Childhood Home Visitation During COVID-19.

COVID-19 has disrupted many of the preventive service sectors designed to serve mothers at-risk for developing postpartum depression, forcing a rapid transition to telehealth-based modes of delivery. The purpose of this study was to explore differences in early childhood home visitation service provision (enrollment and depression screening) among mothers receiving home visitation services prior to and after the onset of the COVID-19 pandemic. Additional factors related to receipt of virtual home visitation services, family risk factors, and the maternal depressive symptoms were examined. Linear and logistic regression were utilized to examine whether there were differences in family risk factors, the percentage of mothers being screened for depression and maternal depressive symptoms, and associations between risk factors and positive depression screenings, while accounting for clustering by site. Samples compared outcomes for families enrolled during the pre-pandemic period (defined as March 16th to July 27th, 2019, n = 4,743) and the post-pandemic period (defined as March 16th to July 27th, 2020, n = 2,049). Families enrolled after the onset of the pandemic were significantly less likely to be impacted by housing instability, have a child with a disability, or be involved with the military, but more likely to have a history of child abuse or neglect. Fewer mothers were screened for depression during the pandemic and maternal report of depressive symptoms decreased. Virtual home visitation is currently attracting some groups of mothers who are experiencing fewer stressors, which may place them at decreased risk for exhibiting depressive symptoms. There may be aspects of the virtual depression screening experience that make detection more difficult. As a result, many mothers at risk for maternal depression may not receive adequate prevention services.

Voice-Activated Virtual Home Assistant Use and Social Isolation and Loneliness Among Older Adults: Mini Review.

A lack of social connectedness is common among older adults due to living alone, loss of loved ones, reduced mobility, and, more recently, social distancing created by the global Covid-19 pandemic. Older adults are vulnerable to social isolation and loneliness, which pose significant health risks comparable to those of smoking, obesity, physical inactivity, and high blood pressure. A lack of social connectedness is also correlated with higher mortality rates even when controlling for other factors such as age and comorbid conditions. The purpose of this mini review was to explore the emerging concepts of older adults' use of commercially available artificial intelligent virtual home assistants (VHAs; e.g., Amazon Echo, Google Nest), and its relationship to social isolation and loneliness. A secondary purpose was to identify potential areas for further research. Results suggest that VHAs are perceived by many older adult users as “companions” and improve social connectedness and reduce loneliness. Available studies are exploratory and descriptive and have limited generalizability due to small sample sizes, however, similar results were reported across several studies conducted in differing countries. Privacy concerns and other ethical issues and costs associated with VHA use were identified as potential risks to older adults' VHA adoption and use. Older adults who were using VHAs expressed the need and desire for more structured training on device use. Future research with stronger methods, including prospective, longitudinal, and randomized study designs are needed. Public education, industry standards, and regulatory oversight is required to mitigate potential risks associated with VHA use.

Taking stock: delivering care home primary care.

NHS England-led changes to the way we deliver primary care to our care home residents were due to start in October 2020; however, because of the unexpected COVID-19 pandemic, these changes were accelerated.1 Changes involved not only structural changes by allocating care homes to particular Primary Care Networks but also an emphasis on virtual home rounds with the use of information technology (IT) and a focus on personalised care.2 Haxby Group in York provides primary care to residents in nine care homes. The primary care and care home staff have worked tirelessly to bring the changes, as stipulated in the service specification, to fruition.3 As more than a year has now passed since the inception of these changes, and as we begin to emerge from the pandemic, we wished to reflect on these changes and draw upon these reflections to inform future care planning. To capture these reflections, we conducted two anonymous questionnaires. The first was sent to care home managers in our network. We asked them not only to provide reflections …

Promoting Culture Change Within Organizations.

Promoting Culture Change Within Organizations.

Medication Adherence Reminder System for Virtual Home Assistants: Mixed Methods Evaluation Study.

BackgroundMedication nonadherence is a global public health challenge that results in suboptimal health outcomes and increases health care costs. Forgetting to take medicines is one of the most common reasons for unintentional medication nonadherence. Research findings indicate that voice-activated virtual home assistants, such as Amazon Echo and Google Home devices, may be useful in promoting medication adherence.ObjectiveThis study aims to create a medication adherence app (skill), MedBuddy, for Amazon Echo devices and measure the use, usability, and usefulness of this medication-taking reminder skill.MethodsA single-group, mixed methods, cohort feasibility study was conducted with women who took oral contraceptives (N=25). Participants were undergraduate students (age: mean 21.8 years, SD 6.2) at an urban university in the Southeast United States. Participants were given an Amazon Echo Dot with MedBuddy—a new medication reminder skill for Echo devices created by our team—attached to their study account, which they used for 60 days. Participants self-reported their baseline and poststudy medication adherence. MedBuddy use was objectively evaluated by tracking participants’ interactions with MedBuddy through Amazon Alexa. The usability and usefulness of MedBuddy were evaluated through a poststudy interview in which participants responded to both quantitative and qualitative questions.ResultsParticipants’ interactions with MedBuddy, as tracked through Amazon Alexa, only occurred on half of the study days (mean 50.97, SD 29.5). At study end, participants reported missing their medication less in the past 1 and 6 months compared with baseline (χ21=0.9 and χ21=0.4, respectively; McNemar test: P<.001 for both). However, there was no significant difference in participants’ reported adherence to consistently taking medication within the same 2-hour time frame every day in the past 1 or 6 months at the end of the study compared with baseline (χ21=3.5 and χ21=0.4, respectively; McNemar test: P=.63 and P=.07, respectively). Overall feedback about usability was positive, and participants provided constructive feedback about the skill’s features that could be improved. Participants’ evaluation of MedBuddy’s usefulness was overwhelmingly positive—most (15/23, 65%) said that they would continue using MedBuddy as a medication reminder if provided with the opportunity and that they would recommend it to others. MedBuddy features that participants enjoyed were an external prompt separate from their phone, the ability to hear the reminder prompt from a separate room, multiple reminders, and verbal responses to prompts.ConclusionsThe findings of this feasibility study indicate that the MedBuddy medication reminder skill may be useful in promoting medication adherence. However, the skill could benefit from further usability enhancements.

Shifting from in-person to virtual home visiting in Los Angeles County: Impact on programmatic outcomes

PurposeThis paper describes the effect that the COVID-19 pandemic, and subsequent shift from in-person to virtual (video-based) home visiting, had on the Los Angeles County Welcome Baby Home Visiting Program.DescriptionThe Welcome Baby (WB) Program is a voluntary, universal home visiting program for expectant women and women with infants in Los Angeles County implemented in 14 hospitals in Los Angeles County. Oversight of the program is managed by LA Best Babies Network (LABBN) and funded by First 5 LA. The COVID-19 pandemic forced Welcome Baby Home visitors to shift from in-person home visits to virtual visits, which had an impact on programmatic outcomes.AssessmentLABBN manages a database utilized by WB sites. In assessing data trends before and during the pandemic, shifting to virtual visits resulted in an increase in both missed visits and completed visits, and a decrease in overall visit length. Completion of required assessments and overall client program completion were not affected by the COVID-19 pandemic.ConclusionThe Welcome Baby sites across Los Angeles County were able to successfully migrate in-person visits to a virtual platform, proving that virtual visits are possible and do provide some programmatic benefits. However, the long-term efficacy of virtual visits remains to be seen, and further research is warranted.

Using Evidence-Based Learning Theories to Guide the Development of Virtual Simulations.

Technology-enhanced training such as virtual simulations can be effective only to the extent evidence-based principles of learning are integrated into their training platforms. Assuming skill acquisition is the target of training, programs should include time and space for repeated practice opportunities structured through evidence-based learning theories (Amodeo et al. in Adm Soc Work 33:423–438, 2009). Essential learning attributes derived from Cognitive Load Theory (Sweller in Cognit Sci 12:257–285, 1988) and the Theory of Deliberate Practice (Ericsson et al. in Psychol Rev 100:363–406, 1993) can effectively integrate into virtual simulations intended to build expertise. Virtual Home Simulation (VHS) and Virtual Motivational Interviewing (VMI) are presented in this paper as an approach to develop virtual simulations that provide child welfare workers a means to deliberately practice essential skills toward competence before entering the workforce. This paper reviews the development process, specific design aspects, and lessons learned as a guide on how to integrate effective learning attributes. Implications for using virtual simulations, including cost-benefits, measuring performance over time, and addressing training complications due to Covid-19 or similar obstacles, are also provided.

Facial Emotion Recognition from an Unmanned Flying Social Robot for Home Care of Dependent People

This work is part of an ongoing research project to develop an unmanned flying social robot to monitor dependants at home in order to detect the person’s state and bring the necessary assistance. In this sense, this paper focuses on the description of a virtual reality (VR) simulation platform for the monitoring process of an avatar in a virtual home by a rotatory-wing autonomous unmanned aerial vehicle (UAV). This platform is based on a distributed architecture composed of three modules communicated through the message queue telemetry transport (MQTT) protocol: the UAV Simulator implemented in MATLAB/Simulink, the VR Visualiser developed in Unity, and the new emotion recognition (ER) system developed in Python. Using a face detection algorithm and a convolutional neural network (CNN), the ER System is able to detect the person’s face in the image captured by the UAV’s on-board camera and classify the emotion among seven possible ones (surprise; fear; happiness; sadness; disgust; anger; or neutral expression). The experimental results demonstrate the correct integration of this new computer vision module within the VR platform, as well as the good performance of the designed CNN, with around 85% in the F1-score, a mean of the precision and recall of the model. The developed emotion detection system can be used in the future implementation of the assistance UAV that monitors dependent people in a real environment, since the methodology used is valid for images of real people.