Telerehabilitation Program in Rural South India: A Mixed-Method Analysis of the Shared-Decision Making Process

Authors

Sylvia Langlois, University of TorontoFollow
Caroline Eagles, University of CalgaryFollow
Dinesh Krishna, University of TorontoFollow
Navamani Venkatachalapathy, Amar Seva SangamFollow
Tim Bressmann, University of TorontoFollow
Franzina Coutinho, Amar Seva SangamFollow

Abstract

Purpose: Shared decision making (SDM) in health care teams involves partnering with the patient and family to consider treatment options, prioritizing their values and preferences while collaboratively determining the best care plan. Previous research on SDM in rural South India has only focused on adult populations receiving in-person care. This study aimed to understand parent perception of the SDM approach implemented in telerehabilitation services offered by Amar Seva Sangam Ayikudy to children with disabilities in a rural Southern Indian setting. Methods: A convergent parallel mixed-methods design was utilized. Quantitative data was collected from 187 participants using a SDM measure examining parents’ perceptions of whether SDM was implemented. Additional qualitative data was gathered through 3 virtual focus groups. Results: Most SDM measure respondents (71.7%) reported engaging in SDM, a finding also shared by parents in the focus groups. Thematic analysis of focus group responses revealed four themes: intentionally positioning the parent as an expert within the care team, building capacity and transferring knowledge, enhancing participation through in-person community resource worker support, and valuing the family context in making decisions. Additionally, parents requested more treatment sessions to address their children’s needs. Conclusions: This study enhances understanding of parent engagement in the SDM process with the team providing telerehabilitation services. These insights may guide family engagement in virtual service provision in other settings.

Author Bio(s)

Sylvia Langlois M.Sc. OT Reg. (Ont.) is an Associate Director, Academics at the Centre for Advancing Collaborative Healthcare and Education, University of Toronto and University Health Network, Toronto, Canada. She is also an Associate Professor with the Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Canada.

Ms. Caroline Eagles M.Sc. is an Occupational Therapist with Carewest Innovative Health Care, Calgary, Canada. She was an M.Sc. student in Occupational Science and Occupational Therapy student at the University of Toronto at the time of conducting this research.

Dr. Dinesh Krishna M.D. is the Director of Strategy, Enabling Inclusion, Amar Seva Sangam, Tamil Nadu, India and the Director at Handi-Care International, Toronto, Canada. Additionally, he is a lecturer in the Department of Family and Community Medicine, University of Toronto, Toronto, Canada

Ms. Navamani Venkatachalapathy BPT, MBA is the Head, Implementation, Innovation and Capacity Building, Amar Seva Sangam-Centre of Excellence, Tamil Nadu, India.

Dr. Tim Bressmann PhD.is an Associate Professor, Department of Speech-Language Pathology, Temerty Faculty of Medicine, University of Toronto, Canada.

Dr. Franzina Coutinho PhD. is the Research Director, Amar Seva Sangam, Tamil Nadu, India and the Clinical Director, Inspirium Holistic Care Mumbai, Maharashtra, India. She is also an Affiliate Member of the School of Physical & Occupational Therapy, McGill University.

Recommended Citation

Langlois S, Eagles C, Krishna D, Venkatachalapathy N, Bressmann T, Coutinho F. Telerehabilitation Program in Rural South India: A Mixed-Method Analysis of the Shared-Decision Making Process. The Internet Journal of Allied Health Sciences and Practice. 2026 Mar 03;24(1), Article 20.