Date of Award

8-17-2024

Document Type

Dissertation

Abstract

People of Alaska Native and American Indian heritage living in rural areas of Interior Alaska experience significant barriers to accessing healthcare, including availability and accessibility of mental health services and varying levels of acceptance by communities. Telehealth has been used to enhance health access in underserved areas. Little is known about how mental health providers use and experience telehealth while working with tribal health beneficiaries in rural Alaska. This dissertation sought to explore the phenomenological experiences of mental health providers using a Community Based Participatory Research approach. Eight in-depth interviews were conducted with providers at Tanana Chiefs Conference about their post-COVID experiences using telehealth. Qualitative analysis revealed that providers experienced a paradigm shift after COVID, whereby telehealth became a predominant mode of communication. Telehealth improved health access and was acceptable and effective for clients and telesupervision. They noted differences in rapport building, client engagement, and attendance of appointments. Internet access, privacy, and mental health stigma were reported barriers to accessing telehealth. Recommended best practices include understanding the clients’ context in depth, practicing patience and flexibility, and being mindful of clients’ safety, privacy, and local resources. The first implication of the findings is that telehealth is a beneficial tool that increases the availability and accessibility of health services in rural areas, but does not resolve health provider shortages. Second, limits on telesupervision hours, despite its perceived efficacy, may inhibit capacity building in rural and underserved areas. Further provider training and soundproofing may improve acceptability of health services in rural areas.

Handle

http://hdl.handle.net/11122/15550

Available for download on Thursday, August 13, 2026

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