Date of Award

Spring 2026

Degree Type

Thesis

Department

Public Health

Director of Thesis

Nabil Natafgi

Second Reader

Amy Ray

Abstract

Telehealth has become an increasing part of healthcare service delivery, expanding client access to services across disciplines, including occupational therapy. Existing research suggests that telehealth occupational therapy can produce similar outcomes to in-person care in certain populations; however, variability in patient characteristics, technological readiness, intervention demands, and environmental contexts influences its suitability, and limited research examines how practitioners determine the appropriate service delivery model. The purpose of this qualitative study is to explore the factors that influence occupational therapy practitioners within a Veterans Affairs healthcare setting in South Carolina when determining the appropriateness of telehealth, in-person, or hybrid service delivery models.

A qualitative study using semi-structured interviews was employed with six occupational therapy practitioners. Data were analyzed using an inductive thematic analysis approach to identify patterns across participant responses.

Findings indicate that telehealth is most effective for consult-based services, environmental assessments, and patient education, but less effective for interventions that require hands-on assessment and treatment. Technology-related barriers, caregiver availability, and institutional support were identified as key factors influencing telehealth use. Participants emphasized that clinical judgment plays a central role in determining appropriateness and that hybrid models are the most workable approach to balancing accessibility and clinical effectiveness. These findings suggest that telehealth should be used selectively within occupational therapy practice based on patient needs, intervention requirements, and contextual factors. The results provide guidelines to support clinical decision-making, highlighting the importance of continued development in training, technology, and system-level support to optimize telehealth implementation.

First Page

1

Last Page

45

Rights

© 2026, Christina R. Smith

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