Measuring factors associated with telehealth use by people who use mental health services: A psychometric analysis of a theoretical domains framework questionnaire

Introduction: Telehealth has the potential to improve access to mental health care, especially for people living in rural and remote regions. Yet, telehealth accessibility remains a challenge in Australia, and there is a scarcity of appropriate, psychometrically sound tools for evaluating telehealth use by mental health service users. The aim of this study was to adapt and validate a scale for measuring factors associated with mental healthcare telehealth use.

Methods: A 39-item scale was adapted from the Theoretical Domains Framework questionnaire (TDFQ); a 14-domain framework for measuring implementation of evidence-based practice in health research and service delivery. Since use of the TDFQ in the service user and telehealth space is novel, we adapted and piloted the TDFQ using a rigorous and iterative consultation process and analysis. The study sample included 208 people who use mental health services (52% male). Preliminary analysis identified 32-items for inclusion in the exploratory factor analysis. Internal reliability and construct validity were also analysed.

Results: The resulting 21-item telehealth adaption of the TDFQ includes four factors, each with good internal reliability: satisfaction and habit (6 items), knowledge and training (5 items), benefit and value (6 items), and emotionality (4 items). Both the total scale and individual factors were positively associated with telehealth use.

Discussion: The telehealth adaption of the TDFQ is a psychometrically sound tool for assessing factors associated with the use of telehealth by people who use mental health services.