It's better than telephone, and it's better than driving to Thunder Bay: Clients' perceptions of experiences in participating in a group-based stroke self-management program using videoconference technology

PURPOSE: Videoconference is used in rural and remote areas to improve access to healthcare, including individual clinical assessments and the delivery of group education. Moving On after Stroke (MOSTRTM ) is a group-based, self-management program for stroke survivors and their caregivers, which consists of information sharing, facilitated discussion, goal-setting, and exercise. The program was delivered simultaneously to local participants onsite and distant participants using videoconferencing (MOST-Telehealth Remote). This research was designed to learn about the experiences of the remote participants, their perceptions regarding perceived enablers and barriers to videoconference participation, and suggestions for improvement.;FINDINGS: All participants valued accessible programming without having to travel long distances. Many reported "feeling as if they were in the same room" but also acknowledged that there were technical limitations when participating via videoconference. They recognized a loss of subtleties in communication. Factors facilitating engagement and participation were similar to factors in face-to-face groups and included: program content; having a skilled group leader; and having a connection to another group member, rather than the videoconference environment itself. The importance of onsite coordinators, volunteers, and the presence of other local participants were highlighted. Suggestions for improved group cohesion and participation included having a preliminary face-to-face meeting, implementing technical strategies, and having onsite support.;CONCLUSION: For MOST-TR participants, the benefits of videoconference participation outweighed the shortcomings. Addressing the limitations of videoconference connection and providing local support may improve the experience for rural participants in small-group, videoconferenced, support programs.;METHODS: Semi-structured interviews were conducted in person with nineteen rural MOST-Telehealth Remote (MOST-TR) participants within one year post-program. The interviews were transcribed and coded using NVivo 2.0. Data were analyzed for common categories using qualitative descriptive methods.