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2023 HSR&D/QUERI National Conference Abstract

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4046 — A Novel “Video Visit User Experience” Survey Measure to Assess Veterans’ Experiences with Virtual Care

Lead/Presenter: Cindie Slightam,  COIN - Palo Alto
All Authors: Slightam CA (HSR&D Palo Alto), SooHoo, S (HSRD Palo Alto); Zulman, DM (HSRD Palo Alto); Kimerling, R (HSRD Palo Alto)

Objectives:
To develop and assess the psychometric properties of the Video Visit User Experience (VVUE) measure, a novel patient-reported measure of experiences with VA virtual care.

Methods:
Development of the VVUE survey measure took place over three phases: (1) Item Generation, (2) Measure Development, and (3) Measure Evaluation. In step 1, we derived candidate items from existing surveys, literature review, and expert opinions. The RAND Conceptual Framework for video visit patient experience guided the identification of domains. Items were tested for content validity with an expert review panel (n = 7) and cognitively tested with Veterans (n = 6). In step 2, candidate items were included in a national survey of Veterans (conducted in partnership with VA’s Office of Connected Care) that examined Veterans’ access to and experiences with VA virtual care. The survey was sent to a sample of active VA users with previous video visit use and/or receipt of a VA issued tablet 3-6 months prior to recruitment. Veterans could complete the survey online and by phone or mail. The survey included the candidate VVUE items (4-point scale from Strongly Disagree to Strongly Agree), questions about patient engagement), use of other VA technology, satisfaction with VA and sociodemographics. We identified survey respondents who self-reported using VA Video Connect (VVC) in the last 6 months (N = 1,924) and removed 36 cases with missing values on the VVUE items. In step 3, the final sample from step 2 (N = 1,888) was randomly split in half; we conducted exploratory factor analysis (EFA) with the first half and confirmatory factor analysis (CFA) with the second half to assess structural validity.

Results:
Of the 27 initial items, 8 items were removed during development, and 19 items were evaluated in the national survey. Bartlett’s test of sphericity (X2 = 5508, p < .001?) showed the correlation matrix was factorable and Kaiser-Meyer-Olkin (0.93) justified sampling adequacy. Principle factor analysis using polychoric correlation matrix and promax rotations were conducted. Nine items were removed because of high correlations (> .90), vague wording, cross-loading, or because they were not conceptually meaningful. After an iterative EFA process and expert review, a 10-item single-factor measure emerged that explained 96% of the total variance. The McDonald’s Omega was 0.95, indicating adequate internal consistency reliability and structural validity. The CFA results confirmed the single-factor solution (CFI = 0.96, TLI = 0.94, SRMR = 0.04). The VVUE survey measure queries Veterans about the degree to which they agree with experiences such as the ease of using the technology, availability of technical support, privacy concerns, audio and visual quality, and intent to use video visits in the future.

Implications:
The Video Visit User Experience (VVUE) measure is a brief survey tool that may be used to capture Veterans’ experiences receiving VA virtual care. This measure is validated for use in the VA patient population and can complement other VA self-report measures.

Impacts:
Researchers and clinicians can use VVUE measure to learn more about Veterans’ experiences using video care technology and how it can improve health care quality, safety, and communication with providers within VA.