Table 3.
Selected care access expansion digital health interventions (virtual care/telehealth).
| First author, year | Study design | Description of technology | Sample size | Selected outcomes |
| Aikens, 2015 [20] | Observational cohort | Weekly IVRa calls for depression self-management. Option to designate a lay support person to receive email reports summarizing reported symptoms and providing problem-tailored support guidance. | 221 patients | Increases of 20% in the per-week aORb for medication adherence and 16% for depression remission compared with controls. |
| Coker, 2019 [58] | RCTc | Telehealth-enhanced referral to a CMHCd using informational videos, SMS text messages, and telehealth screening at the primary care clinic. | 342 Latino children | aOR 3.02 (95% CI 1.47-6.22) for completing CMHC visits compared with controls. Telehealth referrals took longer to complete screening but reported greater satisfaction with referral than controls. |
| Halterman, 2018 [103] | RCT | Videoconference telemedicine visit in a school health office for asthma baseline and medication; follow-up telemedicine assessments every 4-6 weeks. | 400 urban students | 0.69 (95% CI 0.15-1.22) more symptom-free days per 2 weeks (P=.01). aOR 0.52 (95% CI 0.32-0.84) for asthma-related EDe visit or hospitalization. |
| Osofsky, 2017 [178] | Pre-experimental time series | Onsite and/or telemedicine behavioral-based trauma treatment delivered in primary care clinics. | 235 patients | 4.5-point decrease in the PCL-Cf score (P=.001), and 1.8-point decrease in the PHQ-15g score (P=.001). |
| Perry, 2018 [181] | RCT | Live video telemedicine asthma education at school for a child, caregiver(s), and school nurse; telemonitoring of patient-reported symptoms; PCPh prompts with guideline-based asthma management. | 393 rural African American students | No change in symptom-free days, quality of life, or lung function. 42% increase in peak flow meter use compared with controls (P<.01) and 19% increase in medication adherence (P=.03) over 6 months. |
| Reeves, 2016 [186] | Pre-post | Implementation of EHRsi in the school system for the asthma care program; messaging connection to PCP EHR systems; school nurse asthma template for PCP messaging. | 33 students | 39.4% decrease in asthma inpatient admissions (P<.001) and 18.2% decrease in exacerbations (P<.05) over 12 months. |
| Richter, 2015 [189] | RCT | Live video telehealth for tobacco cessation delivered in primary care clinics. | 566 patients | No difference in biochemically verified prevalence, prolonged abstinence, quit attempts, or number of cigarettes smoked per day compared with phone counseling. |
aIVR: interactive voice response.
baOR: adjusted odds ratio.
cRCT: randomized controlled trial.
dCMHC: community mental health clinic.
eED: emergency department.
fPCL-C: posttraumatic stress disorder checklist-civilian version.
gPHQ-15: 15-item patient health questionnaire.
hPCP: primary care physician.
iEHR: electronic health record.