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1. Telerehabilitation is defined by ReLAB-HS as, “the delivery of rehabilitation services using information and communication technologies and is proposed as an alternative to in person consultation to provide rehabilitation.” Furthermore, it “encompasses a range of rehabilitation services that include assessment, monitoring, therapy, prevention, supervision, education, consultation, and counseling.”
This proposed intervention supports the priorities to increase access to rehabilitation services for those with unmet needs in an equitable and resource-efficient way. It recognizes that in LMICs rehabilitation services are limited in scale and scope of practice leaving many without access to rehabilitation care. Additionally, as an evidenced-based practice driven organization, telerehab is promising because promising evidence is emerging to support it’s impact and cost-effectiveness. Importantly, telerehab can also be used for professional development of local staff to increase the strength of the local health system, and perhaps ultimately decrease the initial significant need for remote services.
Regarding it’s fit with community values, I would need to study the intended group as there is no “one-size fits all” approach to rehabilitation in general, but in particular regard to community values. For example, some communities may have gender preferences for clinicians. Other communities may have community concerns over the use of technology, particularly on religious holy days. Engaging all stakeholders can help develop a telerehab program that is suitable to the intended community, and ultimately avoid culturally insensitive words or actions.

2. For a stakeholder analysis I would use the pre-implementation strategies of qualitative, in-depth research, including key informant interviews and surveys to assess true stakeholder engagement and staff/organizational readiness, needs and capacity. I would use information from other implementation efforts to contextualize the current situation and help inform changes at this pre-implementation stage. I could use dissemination strategies such as developing intervention advertising to targeted participants. Project Last Mile, supported by the CocaCola Foundation, Gates Foundation, USAID and PEPFAR has had tremendous success in this area. They’ve been able to leverage Coca-Cola’s distribution expertise to help navigate supply chain management issues in African LMICs while also using their branding expertise. ( In this way, they support both the supply and the demand for healthcare services. I would closely examine the guideposts they have used, and shared, to help promote uptake of services – and to ensure that those services are unique and intentional to the community at hand.

Integration strategies which optimize intervention accessibility and success include reminder systems, staff coaching, regular review of staff roles, process and procedures. I have worked at NYP-Cornell Weill Medical Center in NYC and over the years I have seen meetings such as these transform from a top-down to a blend of bottom-up feedback. Now, they are referred to as “Town Hall Meetings” giving staff a chance to voice what is working and what isn’t. This allows training sessions to be more informative as they can be tailored to areas of need, rather than rudimentary review of areas already successfully adopted.
Capacity building strategies aim to improve the motivation and capability of organizations, offering technical assistance and opportunities for peer working and developing. Leadership offers individuals the opportunity to grow their professional and leadership skills. By fostering a a learning and networking environment, the organization, and our intervention of telerehab, has the best chance of success. Again, I refer to Project Last Mile – an organization I studied in a supply chain management class. Specifically, I am thinking of the “Girl Champ” brand that was developed in eSwatini to support adolescent girls and young women decrease their risk of HIV infection. (1). Networking allows transfer and development of thought and experience leading to broader and more encompassing outcomes for the organization than a linear, top down approach.

(1) Brault, M. A., Christie, S., Aquino, S., Rendin, A., Manchia, A., Curry, L. A., & Linnander, E. L. (2021). Project Last Mile and the development of the Girl Champ brand in eSwatini: engaging the private sector to promote uptake of health services among adolescent girls and young women. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 18(1), 52–63.