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Telemed J E Health. 2016 Jan;22(1):31-5. doi: 10.1089/tmj.2015.0021. Epub 2015 Jul 23.

Attitudes Towards Implementation of Store-and-Forward Telemental Health in Humanitarian Settings: Survey of Syrian Healthcare Providers.

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1 Department of Psychiatry, Yale School of Medicine , New Haven, Connecticut.
2 Yale School of Public Health , New Haven, Connecticut.



Store-and-forward (S&F) telemedicine is thought to be most applicable in humanitarian settings. Unlike other kinds of telemental health (TMH), S&F requires engagement and active participation from healthcare providers in submitting text or audio-video clinical material for consultations. To implement such consultative systems there is a need to gauge providers' attitudes towards this technology.


An electronic survey was sent to Syrian healthcare providers (physicians and nonphysicians) who are affiliated with humanitarian nongovernmental organizations managing Syrians affected by war. After a description of what TMH and S&F are, participants were asked about their attitudes towards such services.


Fifty-two providers responded to the electronic survey. Only results from providers inside Syria (n = 30) are presented. The majority of respondents had no experience with TMH. Half of the providers believed that mental healthcare can be provided through S&F and that there would be a benefit from such services. Respondents reported that cultural (68%), financial (84%), and technical (80%) barriers do exist for such services. When asked, providers believed that patients would agree to be audiotaped (58%) for the purpose of S&F compared with being videotaped (15%) (p = 0.007).


Electronic surveys of healthcare workers in humanitarian settings are feasible. Providers in the Syrian humanitarian setting have little experience in TMH; however, they are open to using an S&F service while acknowledging cultural, financial, and technical barriers to the implementation.


behavioral health; telehealth; telemedicine; telepsychiatry

[Indexed for MEDLINE]

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